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Home My WebLink About2014-00678 - new water & sewer connection � ' CITY OF ORONO * 2 0 1 4 - PJ 0 6 7 8 * 2750 KELLEY PARKWAY DATE ISSUED: 07/O1/2014 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 2385 GLENDALE COVE LA PIN : 34-118-23-33-0069 LEGAL DESC : GLENDALE COVE : LOT O10 BLOCK 001 PERMIT TYPE : SF.:WER& WATER VROPERTY TYPE : RGSIDENTIAL CONSTRUCTION TYPE : CONNEC'I�ION NO"I�L'.: NI?W W,1T�?R&SEWER CONNt�.C"I�IUN P1PE SI'!.E-4" PVC SCHI�:DULP.40 MATI;RIAI, PIPF SI%F,- I" MATI�RIAL ENDO SCIIF.DULE-40 APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 WATER CONNECT/DISCONNECT/REPAIR 50.00 SCHERBER COMPANIES I 1415 VALLEY DRIVE STATE SURCHARGE SEWER& WATER 5.00 ROGERS, MN 55374- TOTAL 105.00 Payment(s) CHECK 15900 105.00 OWNER ALPINE CAPITAL 9401 73RD AVE. N #400 BROOKLYN PARK, MN 55428- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant perniission for additional or related work which requires separate permits. All provisions of laws and ordinanccs govcrning this typc of work shall be compied�vith�vhether or not spcciticd herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days uf the date of issuance,or if construction is suspended for a period of I 80 days at any time after work has commenced. I�he applicant is responsible Yor assuring all required inspections are requcsted in conformance�vith the State Ruilding Code.This permit may be revoked� � n time � r d �cause. � ( � `� � �.-� 7 i l i! Appl ca�it Pernu ee Signature Dat�, Issue l3y Signature Date l , - FOR CITY USE ONLY � ��' ��/�I �- City of Orono Date Received: Permit# �Q (Y � �`, P.O.Box 66 /l 1 — `i 2750 Kelley Parkway ❑In-House SAC Determination Form Completed \� ' Crystal[3ay,MN 55323 .� �� (952)249-4600/F�(952)249-4616 Approved By(If Required): ''�i�ii.,c� CITY OF ORONO—SEWER& WATER/GENERAL PERMIT (*Note:Some permits may require approval by the Building Official and/or Public Works Department*) (ALL PERMI'i'S- Mav be subiect to further review and mav not be issued when the a�olication is received) GENERAL INFORMATION 1. You may apply for utility permits by mail or in person at the City offices. 2. Mailed in applications are subject to the postage and handling fee shown below. Permit cards will be sent by return mail within 2 business days. 3. Permits are not valid until you receive a permit card. 4. Work must not begin unless the permit card is available on the job site. 5. Utility connection permits may be issued to licensed contractors only. 6. Contact the Public Works Department(952-249-4600)for utility stub as-built locations. DO NOT EXCAVATE IN ANY STREET A1vD DO NOT TAP ANY MAIN without express approval of the Public Works Department. Issuance of a permit does not grant this approval. 7. All work must be done in accordance with State Code requirements. 8. All work must be inspected before it is covered. Call(952)249-4600,24+hour notice required. TYPE OF PERMIT Check All That A 1 �iResidential(May Require Approval) ❑Commercial(Approval Required) [� New Connection ❑Additional Connection ❑ Re-Connection ❑ Repairs ❑ Disconnect ❑ Water Availability Connection For Future Hook-Up to Water Job Site / Owner Information: Site Address: ��J ��G �,�,,C�� L.� Owner: (.�K, ��"�111+1 T 1(�,�(Y1Q� Mailing Address: DZ�t� l L�� • City: �1��-� Zip: ��.>� Home Phone: Alternate Phone: 1�, '�t�'�i�`�i Contractor Information: Contractor: �X,�ZX��-� ��'V1:Qt.'��i1X�-�Contact Person: e .�t� /' Address: �.� �� ' �(' State License #: City: '-Z-�� Zip:� Expiration Date: Phone: (p�'2= r• •�t�.if� 1�12 -S �Z :1�L 5 Alternate Phone: � [ } , . DETERMINING PERMIT FEES ❑ SAC Charge(2014 Rate=$2,485.00) $ (SAC Charge must accompany all sewer permit applications unless prepaid) (Orono City Staff can determine if applicable) (If not prepaid,a sewer connection permit will not be issued) �Sewer Con ction/Disconnect/ e air($50.00/Per Stub) $ ��\� Pipe size '� inches;material��Schd 40 air tested; cast iron ch C� [�Water Conne�tion/Disconnect/Repair($50.00/Per Stub) $ -�/ • Pipe size�__inches;material y1d�i Schd 40 air tested; copper ❑ Water Availability For Future Hook-Up to Water($50.00) $ Water Availabilitv Explanation: Contractor installed line to inside of house for future hook-up. This line will be inspected by the Public Works Deparhnent. Reauired Before Water Connection Permit is Issued: 1. Issue Water Meter&Horn Permit 2. Any Additional Connection Fees Paid(If Applicable) Issue Water Connection Permit: l. Collect Permit Fee&Issue Water Connection Permit 1. SUBTOTAL of Permit Requested: $ I�� 2. STATE SURCHARGE $ 5.00 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ 'DS,.C�C> ADDITIONAL INFORMATION—WATER METERS • WATER METERS must be picked up and paid for at Orono City Hall,these are on a separate nermit. ■ WATER METERS must be set and sealed by Orono Water Department (952) 249-4600, upon completion of ineter installation. The undersigned hereby applies to the City of Orono for issuance of a Utility Permit, agrees to do all work in strict accordance with the ordinances of the City and the regulations of the State of Minnesota, and certifies that all statement ade on this application are, true and correct. � ` Applicant: Date: � � � � � ✓ DATE TIME CITY OF ORONO CALLED IN � INSPECTION OTIC SCHEDULED ;�� 3•�� PERMIT NO.�� —� �� COMPLETED ADDRESS � �� OWNER TE PHONE N.O. a-'� $�' 7/� CONTRACTOR ��S �; ..DESCRIPTION �/�� -�� Q:FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILUNG Q ❑ POURED WALL ❑ MECHANICALRI ❑ LAKESHORENVETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION i Q ❑ RADON SLAB �WATER HOOK-UP ❑ PROGRESS Z ❑ FINAL SEWER HOOK-UP ❑ COMPLAINT �J ❑ DEMfl-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP � ❑'�DEA�FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL � J �PLUMBWG RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEEf YOU:_YES_NO � � COMMENTS: �� C�l y� ID U' G �� '�['il C�,L a �� J �. 0 � � � .�x4 ��/vr{� -' 3j � s' cv�r /rL-�' ° W/ A �%' w � �� • �� Q � � Z w �. :_W � j � �WORK SATISFACTORY:PROCEED L PROJECT COMPLETE W ❑CORRECT WORK&PROCEED C 1 ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED C INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Cali tor the next inspection 24 hours in advance. (952� 249-4600 OwnerlContractor on site: `,��L/l�(�Y° �[? �S Inspector. `�7 C�%I/ White Copyllnspector's File Canary CopylSite Notice