The URL can be used to link to this page

Home My WebLink About2017-00582 - sewer & water connect CITY OF ORONO * 2 0 1 7 — 0 0 S e z * 2750 KELLEY PARKWAY DATE ISSUED: 05/3U2017 ORONO,MN 55356- (952)249-4600 FAX: (952) 249-4616 ADDRESS : 765 BRIDGEWATER DR PIN : 33-118-23-12-0090 LEGAL DESC : STONEBAY SEVENTH ADDITION : LOT 3 BLOCK 1 PERMIT TYPE : SEWER&WATER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : CONNECTION NOTE: SEWER AND WATER CONNECTION APPLICANT SEWERCONNECT/DISCONNECT/REPAIR 50.00 WATERCONNECT/DISCONNECT/REPAIR 50.00 BOLLIG& SONS, INC. STATE SURCHARGE SEWER&WATER 1.00 11401 COLTNTY ROAD 3 HOPKINS,MN 55343- S.A.C. 0.00 (952)938-4133 TOTAL 101.00 Payment(s) CREDIT CARD 9081 101.00 OW1vER Wooddale Builders Inc 6117 BLUE CIRCLE DR LJN[T#101 MINNETONKA,MN 55343- 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 onty 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 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 formance with the State Buildi Code.This permit may be revoked a time for due use. �- � I • I � ,�/ ,l� Applicant Permitee Signature Date Issued B ignature Date Rc�ivED ��j'� ,,�---��, '`� FOR CITY(JSE 9NLY O 4•�/�/O City of Qrono , DateReceived: Pera�t�f � 1 e! . P.O.$ox 66 0� i 2750 Kelley Parkway M AY � 1 � ❑In-House SAC DetemainaHou Foim Completed y � Crystal Bay,MN 55323 f�qACS HOR/�� (952)249-4600/Fax(952��gQ,-q63i�OR�N(� APproved Hy(If Required): � � �I Y v CITY OF ORONO—SEWER& WATER/GENERAL PERMIT (*Note:Some permits may require approval by the Building Official and/or Public Works Department") (ALL PERMITS- Mav be subiect to further review and mav not be issued when the aoallcation is receivedl GENERAL INFORMATIOI�1 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-buiit locations. DO NOT EXCAVATE IN ANY STREET AND DO NOT TAP ANY MAIN without express approvat 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 norice required. TYPE OF PERMIT Check All That A 1 ❑Residential(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 InfQrmation: Site Address: �� '"� ��i��-•-�-"- � � � Owner: L��'��-� Mailing Address: City: d � v,�..-u Zip: Home Phone: Alternate Phone: Contractor Information: �� Contractor: �11�a µ�� -5 Contact Person: ��-�. 5�� Address: ��y° � �a e-� 3 State License#: Q i� ��C�-/`'� �3 City: K�Q�'"-`�S Zip:SS 3y3 Expiration Date: �2-I3 �1�� Phone: `�SZ `/S� '��'� Alternate Phone: �� 2 `�3 `� 2�S� ❑SAC Charge(2016 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 Connection/Disconnect/Repair($50.00/Per Stub) $ Pipe size inches;material Schd 40 air tested; cast uon �Water Connection/Disconnect/Repair($50.00/Per Stub) $ Pipe size inches;material Schd 40 air tested; copper ❑Water Availability For Future Hook-Up to Water($50.00) $ Water Availability Explanation: Contractor installed line to inside of house for future hook-up. This line will be inspected by the Public Works Department. 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: 1. Collect Permit Fee&Issue Water Connection Pemut 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) $ ' ADDI'TIONAL INF4RMAT'TpN-WATER METERS ■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a senarate permit. ■ WATER METERS must be set and sealed by Orono Water Department (952) 249-4600, upon completion of ineter instaltation. 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 a tements m e on this ap cation are,true and correct. Applicant: Date: �' � � ' ��i' L.1�"" .` � � DATE TIME CITY OF ORONO cnLLED IN INSPECTION�Oy�TICE 2scHeouLED ` —�� d• �-�l. PERMIT NO. �✓ �v COMP}ETED � ✓��v auoREss A�YLa� pVyNER LEPHONE NO. � - � CONrRACTOR -��-�� DESCRIPTION vv � `� L��I�� YL 4�j ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING "j ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION � ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT � ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL _ � ❑ DEMO-SITE ❑ SEPTIC INSTALL � OMINERICOItTRACfOR TO MEET YWI:_YES_NO �Z 5��` COMMENT'� � 1�Z i�" , -5�� 4 ��1�� -��o �-��s _ �!` � �� C o �� — ° '� L�'� c c� u � � Q tiv��o- F �eu! C�l i�'1� �'o s�- 5 i� << ��'p,' � � W � � � � WORK SATISFACTORY`.PROCEED �PROJECT COMPLETE w RRECT YYORK 3 PROCEED ❑YSSUE CERTIFlCATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFOREC�NERINO PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. �`�TOTAKEN INSPEC'TOR WILL RETURN !�� ❑STOP ORDER POSTED.CALL INSPECTOR �GTATION ISSUED O INSPECTION REWIRED.CALL TO ARRANGE ACCESS. CaM forthe next inspectfon 24 hours in advance. (952) 249-4600 Owne�ICoMractor on site• Inspeator: White CopyAnapector's Fl� Gnary CopplSib Notk:s l�