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Home My WebLink About2017-00316 - (sewer & water connection) � ' CITY OF ORONO * Z pJ 1 7 - 0 PJ 3 1 6 * 2750 KELLEY PARKWAY DATE ISSUED: 04/04/2017 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 2732 CAROLINE AVE PIN : 20-117-23-24-0041 LEGAL DESC : REG. LAND SURVEY NO. 1451 : LOT 000 BLOCK 000 PERMIT TYPE : SEWER&WATER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : CONNECTION NOTE: SF,WER AND WATER CONNECTION APPLICANT SEWERCONNECT/DISCONNECT/REPAIR 50.00 CHUCK'S EXCAVATING WATERCONNECT/DISCONNECT/REPAIR 50.00 760 WEST 96TH STREET STATE SURCHARGE SEWER&WATER 1.00 CHANHASSEN,MN 55317- TOTAL 101.00 (952)496-2874 Payment(s) Minnesota State License#: SW-L3320 CHECK 5921 141.00 OWNER LUND, ROBERT 2732 CAROLINE AVE 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 goveming this 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 l80 days of the date of issuance,or if construction is suspended for a period of l80 days at any time afrer 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 at any time for due cause. �- /� �.�� '� � � � �7 Appl' nt Permitee Signature Date Issued By ignature Date � ��g`O.ArO \ y Fo�cr�u��orn,� � Cit of Orono Date Received: Pumit# �' � P.O.Box 66 ; 2750 Kelley Parkway ❑In-Ho�tse SAC Determination Form Completed ��, � �-�' Crystal Bay,MN 55323 '� G� \'��s�io�-j �952)249-4600/Fa�c(952)249-4616 Approved By(I2'Required): CITY OF ORONO-SEWER& WATER/GENERAL PERMIT (*Note:Some permiu may require approval by the Building Official and/or Public Works Departrnent•) (ALL PERMITS- Mav be subiect to furt6er review and mav not be issued when the auolicedon is receivedl 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 pemut 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 AND 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 PER.IvI�T Ch,eck All That A i ❑Residential(May Require Approval) ❑ Commercial(Approval Required) ❑ New Connecrion ❑Additional Connection ❑Re-Connection ❑Repairs ❑Disconnect ❑ Water Availability Connection For Future Hook-Up to Water Joi� Site L Ovvner Ir�ormation: Site Address: ��;� � ��1�, r�'� f I ��c'_ ��-� t�f� � Owner: Mailing Address: City: Zip: Home Phone: Alternate Phone: Contractar Information: ` � � �� Contractor: ��,C_,�S �.XC�, Contact Person: � > > Address: 7�"O i.`' �L�{`' �� State License#: �� 5�--� , City: C��-n �ciSSt!1 Zip:SS�I� Expiration Date: ,��'/c� Phone: �;��(��-��'�7`� Alternate Phone: �1�02- `-f��n -��7`� D�'�'F„RI�J�G I'�I�MIT�EES ❑ SAC Charge(2015 Rate=52,485.00) $ (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) �Sew nnect' isconnect/Repair($50.00/Per Stuti) $ Pipe size inches;material t��- Schd 40 air tested; cast iron �f Wat onnection isconnect/Repair(550.00/Per Stub) $ Pipe size 1 inches;material F��1 Schd 40 air tested; copper ❑ Water Availability For Future Hook-Up to Water($50.00) $ Water Availabilitv Exnlanation: Contractor installed line to inside of house for future hook-up. This line will be inspected by the Public Works Department. , Required Before Water Connection Permit is Issued: 1. Issue Water Meter&Horn Pemvt 2. Any Additional Connection Fees Paid(If Applicable) Issue Water Connection Permit: 1. Collect Permit Fee&Issue Water Connection Permit 1. SUBTOTAL of Permit Requested: $ 2. STATE SURCHARGE $ 1.00 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 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 senarate 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 statements made on this application are,true and correct. _---,, � !' Applicant:�� -�!�f/ G'�,/-�� Date: y�y— � � r� � ' DATE TIME CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED �J Z a,,� PERMIT NO. r�,[�17�� COMPLETED ADDRESS ��-3� -Q OWNER � TELEPHONE NO. -S'�`�O/ �� 7� CONTRACT�R � u✓�-/�C �_ � DESCRIPTION ��"`�� 4~j ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL � ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP 41 ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL _ J ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMM ENTS: ��r n�_��L�� r�'► �f'fi"�i�.�E?d � ��C�—��'1 s� � �.�� E?n S.�: G'c��r , �l'�''� �r i I�D� �!/1 � f�-I �l� ��" �(�.� �/ �o �� 5 � -�-�, <��i � �v,�r�� -� �h� t It� � � c�� UPr�' �i �� 'L� �F.t.�rzi 5�'r�/ rt�> Q �1 � �j�� /YJ/_� � W � � W � J O 4��WORK SATISFACTORY:PROCEED �ROJECT COMPLEfE � W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑WRRECT VYORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COA/ERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WILL REfURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REOUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 2a hours in advance. (952) 249-4600 a�vvnerlContractor on site:�,�U e% S �� Inspector: �l�f�� Whits Copyllnspector's File Canary CopylSfte Notke