HomeMy WebLinkAbout2008-00348 - sewer & water connect � . *,
CITY OF ORONO PERMIT NO.: 200&00348
2750 KELLEY PARKWAY
ORONO, MN 55356- �ATE ISSUE�: 10/30/2008
952 249-4600 FAX: 952 249-4616
ADDRESS : 3546 NY PL
PIN : 20-117-23-42-0018
LEGAL DESC : TAYLORS SUBD OF SPRING PARK LO
: LOT 000 BLOCK 000
PERMIT TYPE : SEWER&WATER
PROPERTY TYPE : RESIDENT[AL
CONSTRUCTION TYPE : CONNECTION
NOTE: NEW WA1'ER AND SF,WER CONNECTION.
APPLICANT SEWER CONNECT/DtSCONNECT/REPAIR 35.00
DASEN CO. WATER CONNECT/DISCONNECT/REPAIR 35.00
24245 NATOHEZ
LAKEVILLE,MN 55044 STATE SURCHARGE SEWER& WATER 0.50
S.A.C. 0.00
TOTAL 70.50
OWNER
DRAZAN, MICHAEL& MARY
35461VY PL
WAYZATA, MN 55391-
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 permission for additional or related work which requires separate
permits. All provisions of laws and ordinances governing this type of work
shaii be compied with whether or not specified herein.This permit will
expire and become null and void if construction au[horized 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 afrer work has commenced.
The applicant is responsible for assuring all required inspections are
requested in con w�h t tate Building Code.This permit may be
revoked at ti qr caus
� /Di ��'i c� � /D i�3o i � �
A plicant Permitee Signature Date L d By Signature Date
SEPARATE PERM[TS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
Oct `s0 0� O1 : lOp p. l
FY1R CITY USl�UNLY
City Pf Orono nau Reccivcd: _ Termic#��S �
4�� • r.�,A�►��
� � 27501Gcllay 1'�rkway 0 In-1•louse 5hC Delemtimlion 1���o„���ea
a ••� ,C Cry�tal Wry,MN 353Z3
�y+��Mo�,a (9i2)249-A600 Appronx!l3y(ll'Ruquim.�l):
C�TX OF ORONO-S�:WE�t&WATER/GENERAL PERMiT
('�Note:Somc pcqni4�may rcquiro uppmvul by the t3uilding Otticiol and/or Public Work9 Deportmcnt')
(ALLl'F.�ll'a'S- M�v Ae sebixt to fnrll�r r�iew�Hnd�w,w no16r i�u:aeu.rhen ILe.yonllcxlioe id[ecciva!f
GFNI:RAL INFORMATlON
1. You may apply'ror utility permits by m�il or in perspn at d�e Ciry off cts.
2. Mailcd in applic�ions aro subject io the poslrgC and handling fi�szhown bclow. Pcrrnit cards will
b�sant by ri:tum msil within 2 bacin�,t days.
3. 1'cnmfta are no�vplid until yoa reecive a permit card.
4. W�rk musl aot bcgin unlcss thc�crmit card is eveilablc on thu job silc.
5. Utility conneetioe permiu mAy bc issucd to licensed corrtruct,prs on1y.
6. Contact thc hublic Works Department(952-249-4G00)for utility�tub�c-built locations,
DO NOT EXCAVA'1'�IN ANV STRR.ET ATTD DO NOT TAP ANY MAIN wittioat ezpr�
sPpravAl of tlic Poblia Worlo Depariment. I'gsuance of�pennit cJoes not�rant this approv�l.
7. All work must he drn�e in accordancx witb StHte Codc rcquircmcnts.
8_ AI1 work must be inspectr,d bcforc it is covered. Call(952)z49-4600.�dt6onr potiee requirCd.
'tYPE O[�PERMIT _....�.�. �
(Chcck All That Apply) _ _
�Resi4entixl{May Rcquirc Ap�oval) ❑Commorcial(Approval Rcquircd)
�Ncw Conoediosi ❑Additional Connection ❑Ro-Connection ❑Repai�s ❑Disconnect
3ob Sitc/(hvner]nformation:
s��;nda��.s�: � - ��r . -a�l�Y'-��
.
, _!� � ,���� J
Owncr. • IG �1 )��� C ���j Mailing Address: l':r�`-�' .����-(�V��./✓�
c�ri: s ��u�- ���: �l ,.��/�
., , ' ^1' '� - r , ,, �
H�me rh�n�. : . ':7� Alt�.�rntiu.Phonc:
Contractor lnformstion:
�,
,
Contractor: � .�`�. Coniacl Pcrson: � �CfC����l
J
Aaa�ss: G�� �7 Z�s��L����;#: �- ��%/�-�_
City: � ' ' ��-�.-�- �Zip:� ExpiraLion Datc:
' / ,/ �- /,,� �
PhonC: ..��� '`7(�,'I' ��LL Altk;rnate Phone: CS� ��� �
Oct �0 pa, Ol : llp P• 2
DETERMINING PERMIT FEES
p sAc case���xoos w��=s�,szs.on� s
(SAC CAsagc must accom�any a11 scw�r pamit applicadons uNcss prepaid)
(Orona City SWCI'can dcicrminc if appficable)
(linnt prery�id,a sewer conncetiaa pcMsnit will ooL bc i�aal) C^�'
�Cewct C04oackiiaoi/pi.acn�nscct/Rcp�ir(535.00/Per Stab) !F '
Pipc sizc inch�:malerial Schd 40 air tested; casl iron
�u
�`Waber Cowection/Di�connect/Rcpai�(535.00/Per Stub) $ , � � �
Pipe si��e�____inchcs;matc�iAl Schd 40 air testcd; copp�r �
I. SUi3TOTA1.afPcrvn.l;Rcqu�stad: a
2. STA'�'C SURCHARGE $____�._,...,., •�_
3. POSTAGE&HANDI.ING(�ly a�►Ma�il,ln Applicat�ons) . S 1.50
� ��
4. TpTAI.PEfiMtT H'L�[�(Add Lincs 1-3 Abovc) �S �o :
__ .
AUDIT�ONAL INFORMA'fION—WA"T�R IvfET�R5 "
■ Wi►1I'LR MRTERS must bc picked up and paid for ot Orono Ciry I�lall,t}�ese are on a sdpm�,�,�•
- Ww7'L+K Mt;TERS muat be sec aaa sea�eo Dy Uroao Wahr De�rtneot(ySZ) Z49-4600, upon
cumpiction of inetcr in9ts�llatiun.
Tl�e uadersigncd hereby applies to the City of Omno for issuanec of;u Cltility Pemait,agrees to do
, nll work in strict aocordance witl�thc ordinances of thc City and ihc rcgulations of thc :3i.�ic af
Minnocot�a,a�n,d certif es that s�ll statemients ma this�{,pliwtiori arc,truc and oorrcct.
.
^ �� • �,,� � � V•� ' -U�.
A�licant: ' � Dato-
� —� � �_�-- � iln��Cfi� �'�►'rc�
CITY OF ORONO CALLED IN;�/. . � T� ` ��'T��' '�
�t!
INSPECTION I � SCHEDULEd.�O �'
PERMIT NO. ' COMPLETED
ADDRESS '�-�
OWNER CONTR.��jP�/'l�
TELEPHONE NO. ��r� L�Z ��OI �I DO
� DESCRIPTION ����w"�`�V C�•
� ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL
� WALL BD. ❑ WATER HOOK-UP
Z ❑ ❑ SITE INSPECTION
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
� ❑ DEMO-SITE ❑ SEPTIC MA�NT. ❑ COMPLAINT
J ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
Q
� ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
� ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL
Q OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS: C�l', �J�k(�. c�=�l YY�[�-d �.
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��'WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED �1 ISSUE CERTIFICATE OF OCCUPANCY
� ❑ CORRECT WORK,CALL FOFi REINSPECTION TEMPORARY
� BEFORECOVERING
PERMANENT
['CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN
INSPECTOR WILL RETURN i7 CITATION ISSUED
C,STOP ORDER POSTED.CALI INSPECTOR
[ I INSPECTfON REQUtRED.CALL TO ARRANGE ACCESS.
Call forthe next inspection 24 hours in advance. �952� Z49-46��
OwnerlContractor on ite:
Inspector. �f�g.��
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