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Home My WebLink About2008-00050-old PID# - sewer connect � � " , CITY OF ORONO PERMIT NO.: 2008-00050 � 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: 07/16/2008 952 249-4600 FAX: 952 249-4616 ADDRESS � : 460 EAST LONG LAKE RD PIN : 35-118-23-14-0003 LEGAL DESC : UNPLATTED 35 118 23 : LOT 000 BLOCK 000 PERMIT TYPE : SEWER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : CONNECTION NOTE: SAC PAID P03292- 10/25/00-&RECLAIM FROM DEMO CREDIT 10/2007 APPLICANT SEWER CONNECT/D[SCONNECT/REPAIR 35.00 DAVE'S CONSTRUCTION SERVICES, INC. STATE SURCHARGE SEWER& WATER 0.50 15700 JiJNIPER RIDGE DRIVE RAMSEY, MN 55303 S.A.C. 0.00 TOTAL 35.50 OWNER R[CHMOND,JAKE 233 WALKER AVENUE WAYZATA,MN 55391- AGREEMENT AND SWORN STATEMENT The work for which this permit is issucd shall be performed according to the approvcd plans and specifications,applicable City approvals,and the State Buiiding Code. This permit is for only the work described and does not grant permission for additional or related work which requires separa[e permits. All provisions of laws and ordinances goveming[his type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the State Building Code.This permit may be revoked a any[i for due cause. .. � 6 �t..�� >>z��r.��- c�'� �=✓.,�y.� l / l cJ� `�- �/�— ' -;'� /L„ � (s� Applicant Permitee Signature Date Issued By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. ''' ` _ ��, ,,� . ; �� ,��G . � . �� ; .� ;. ,1 , : ' �``G�i ^��' FOR CITY USE ONLY �:. � O,¢O�O City of Orono _t' ^•.� \ DateReceived: Permit# P.O.Box 66 � �' s�,`�,' 2750 Kelley Parkway ❑ In-House SAC Determination Form Completed a�� Crystal Bay,MN 55323 ��i�.�o` (952)249-4600 Approved By(If Required): �` � asxo$ � �v `'�,� U� CITY OF ORONO—SEWER& WATER/ GENERAL PERMIT �, ;��`' 1 �" �� (*Note:Some permits may require approval by the Building Official and/or Public Works Department*) � '`�V' \� (ALL PERMITS- MaV be subiect to further review and mav not be issued when the application is received) � � \ GENERAL 1NFORMATION ' 1. You may apply for utility pernuts 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 pernut card is available on the job site. 5. Utility connection permits may be issued to licensed contractors only. 6. Contact the Public Works Deparhnent(952-249-4600) for utility stub as-built locations. DO NOT EXCAVATE IN ANY STREET AND DO NOT TAP ANY MAIN without express approval of the Public Works Department. Issuance of a pernut 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 Apply) ❑Residential(May Require Approval) ❑ Commercial(Approval Required) [�New Connection ❑Additional Connection ❑ Re-Connection ❑Repairs ❑Disconnect <� Job Site/ Owner Information: �� Site Address: l�?i; �' [ �>;��' �) �%�a�% Owner: ��.�� i Gh��y/� Mailing Address: City: � Zip: Home Phone: ��'`3 y ��"- ��'2� Alternate Phone: Contractor Information: , i� � �� s ,,L Y— _ , '% Contractor: �%�� S```�• � Contact Person: ��`�� ''� �� , ��_,�,.�� c ' /� �:3.�� Address: /1�1��I'��j-��'r' � State License #: 2G3c�� l �s� � �/z/ �f �T � , City: Zip: Expiration Date: �� y �� Phone: Alternate Phone: � � � „ , � . : .� ❑ SAC Charge(2007 Rate=$1,825.00) $ (SAC Charge must accompany all sewer pernut applications unless prepaid) (Orono City Staff can deternune if applicable) (If not prepaid,a sewer connection permit will not be issued) ❑ Sewer Connection/Disconnect/Repair 5.00/Per Stub) $ Pipe size�inches;material \ �7chd 4 air tested; cast iron --�-- ❑ Water Connection/Disconnect/Repair ($35.00/Per Stub) $ � � �� Pipe size inches; material Schd 40 air tested; copper l. SUBTOTAL of Pernut Requested: $ 2. STATE SURCHARGE $ .50 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ ADDITIONAL INFORMATION—WATER METERS ■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a separate permit. ■ 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 ertifies that all statements made on this application are,true and correct. ,// � l A licant: � /��7' " — � — �� pp Date: � / J �� _�_� / � DAT�h� TIME �` CITY OF ORONO ` �CALIED IN ✓� �� INSPECTION NOTICE � , �,��'��'scHEou�Eo � � -11L[l� PERMIT NO. ,,�I;ll;? COMPLETED ADDRESS D �� - � `� OWNER CONTR � s � TELEPHONE N0. � � ' �`� " �S� -� � 7c.� � DESCRIPTION �- - � � ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GR NG/FILLING ,Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORENVETLANDS y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE tNSPECTION Q ❑ FINAL �SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT v ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP � ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL Z OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: a �X�` s �-�'�5 � - � 1� o o Ke� � f3 Ae� �c��'� ° �. c�, c�� v� � S �� p �C—�' � . � �Dvn ct �4-�-�'c�I�S W � Q � � i2 � � �"' z � �� f t /2L�S�" ?�Q � 1�A�-f S7�( �'/'�� -5-��e�' 1.�� e � � �WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call tor the next inspection 24 hours in advance. (J52� 249-46�� OwnerlContractor on site: Inspector_ 1 � .rt d �� White Copyllnspector's File Canary Copy/Site Notice