HomeMy WebLinkAbout2017-00276 - water/sewer disconnect _ ' � � CITYOFORONO * 2017 - 00276 *
2750 KELLEY PARKWAY DATE ISSUED: 03/28/2017
ORONO,MN 55356-
(952)249-4600 FAX: (952) 249-4616
ADDRESS : 3472 LYRIC AVE
PIN : 17-117-23-43-0074
LEGAL DESC : NAVARRE HEIGHTS
: LOT 018 BLOCK 005
PERMIT TYPE : SEWER&WATER
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : DISCONNECTION
NOTE: WATER AND SEWER DISCONNECTION
APPLICANT SEWERCONNECT/DISCONNECT/REPAIR 50.00
WATER CONNECT/DISCONNECT/REPAIR 50.00
Joshua Markum Bldrs,Inc. STATE SURCHARGE SEWER&WATER 1.00
7867 EASTWOOD RD
MOiJNDS VIEW,MN 55112- TOTAL 101.00
Payment(s)
CREDIT CARD 6071 101.00
OWNER
Joshua Markum Bldrs,Inc.
7867 EASTWOOD RD
MOUNDS VIEW,MN 55112-
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 dces
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 l80 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 at any time for due cause.
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Applicant Permitee Signature Date Issued y ignature Date
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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 furt6er review and mav not be issued w6en the aoolication lv 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 cazds 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 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 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 Information:
Site Address: 347�yric Ave Orono, MN 55319
Owner: Joshua/Markum Builders, Inc. Mailing Address:
City: Zip:
Home Phone: Alternate Phone: 612-998-7818
Contractor Information:
Contractor: Joshua/Markum Builders. Inc. Contact Person: Mark Olson
Address: 7867 Eastwood Road State License#: BC631542
City: Mounds View Zip: 5511 Expiration Date: 03/31/2018
Phone: 612-998-7818 Alternate Phone: 612-940-0041 (Corvl
.
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❑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 Connecti isconnect/R air($50.00/Per Stub) $ 50.00
Pipe size inc , Schd 40 air tested; cast iron
�Water Connect /Disconn epair($50.00/Per Stub) $ 50.00
Pipe size inc es;material Schd 40 air tested; copper
�Water Availability For Future Hook-Up to Water($50.00) $ �e"
Water Availabilitv Exalanation:
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 Permit
2. Any Additional Connection Fees Paid(If Applicable)
Issue Water Connection Permit:
1. Collect Permit Fee&Issue Water Connection Permit
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1. SUBTOTAL of Permit Requested: $ q�rp,p�
2. STATE SURCHARGE $ 1.00
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ . 0 /(/ / D�
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ "��r
ADDITIONAL INFORMATION—WATER METERS
■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a separatepermit.
■ 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: ��2�-� � 0�� Date: 03/05/2017