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HomeMy WebLinkAbout2014-00421 - sewer connect f � CITY OF ORONO * z 0 1 4 - 0 0 4 2 1 * 2750 KELLEY PARKWAY DATE ISSUED: OS/08/2014 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 1565 MAPLE PL PIN : 08-117-23-33-0031 LEGAL DESC : CRYSTAL BAY VIEW : LOT 009 BLOCK 006 PERMIT TYPE : SEWER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : CONNECTION NOTE: NEW Si:WGR CONNEC"I'ION APPLICANT SEWER CONNECT/DISCONNECT/REPA[R 50.00 STATE SURCHARGE SEWER& WATER 5.00 J P SCHMI"I'Z CONSTRUCTION COMPANY LL TOTAL 55.00 16450 1 17TH AVE N MAPLE GROVE, MN 55369- Payment(s) CHECK 11566 55.00 OWNER Maple Place LLC 550 25TH AVE N ST. CLOUD, MN 56303- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall bc 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 pennission for additional or related work which requires separ2te permits. All provisions of laws and ordinances governing[his type of work shall bc compied with whether or not specified herein.This permit will expire and bccomc null and void if construction authorized is not commenced within I 80 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 y for due c � / l/ / Applicant Permitee Signature Dat� Issued y Signature Date f � .-�-'_.�, FOR CITY USE ONLY �f=����!��-�� City of Orono �ate Recei�ee: Pern,it� / P.O.Box 66 ;a Y� �} 2750 Kelley Parkway ❑In-House SAC Determination Form Completed ` Crystal Bay,MN 55323 ' �, ri�*`'� �✓j (952)249-4600/Fax(952)249-4616 Approved By(If Required): ;;�-'.�r:-�"' CITY OF ORONO— SEWER& WATER/ GENERAL PERMIT (*Note:Some permiu�nay requue approval by the Building Ofl�icial and/or Public Works Department*) (ALL PERMI7 S- Ma��be subiect to further review and ma�not be issued when the application is received) GENERAL INFORMATION 1. You may apply far 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 wil] 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: !��� � �� �L .��' �� , '/�_ Owner: ���� ������ Mailing Address: City: Zip: Home Phone: Alternate Phone: Contractor Information: Contractor: .J•f��i�1.YJ`Z ��i�1C�L1 Contact Person: C/ � ���- Address: ����<%1������Z�Z� State License#: ���r� ����� Ciry: ��L��k��'� Zip:��j��Expiration Date: ���-,���1� Phone:����-�����J Alternate Phone: � ! DETERMINING PERMIT FEES ❑SAC Charge(2014 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 iron ❑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 Availabilitv Explanation: 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 1. SUBTOTAL of Permit Requested: $ 2. STATE SURCHARGE $ 5.00 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 far at Orono City Ha11,these are on a se�arate 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 wark in strict accordance with the ordinances of the City and the regulations of the State of Minnesota, and certifies that I st ts made on this application are,true and correct. � __ � Applicant: Date: -���f/ ��-� q -�� � �� � CITY OF ORONO CALLED IN 7� D��� T�_ INSPECTION NOTIC SCHEDULED 7—.�.3�iF �/. D� PERMR NO. — COMPLETED ADDRESS l Sl� ���-- OWNER TE EPHONE NO. - 7� y CONTRACTOR a DESCRIPTION �v � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORFJWEfLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ��SEWER HOOK-UP ❑ COMPLAINT v ❑ DEMO-SITE O SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTAIL ❑ HARD COVER REMOVAL v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL Q OWNERICONTRACTOR TO MEET YOU:_YES_NO y COMMENTS: ��r �J L�i j W ^ � sh► r� / 0 � J O �. � O � W � Q � 2 � W � J a� �1 ORKSATISFACTORY:PROCEED ❑PROJECT COMPLETE W 0 CORRECT VYORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WRHIN HOURS. O PHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION RE�UIRED.CALL TO ARRANGE ACCESS. Cail for the next inspection 24 hours in�vance. (g52) 249-4600 OwnerlContractor on site: �`� Sl' �i •»i-�Z Inspector: ��'-�!=��— White CopyAnspector's File Canary CopylSMe Notice ��ry I�y ���� 1 � yG /�� ����/ '��%i��4•...!% �d � k $ � x -�i, '�., . � n. ` .y� � ��� -; ::��. �� t_ d �� � :� ., .,� � ,. .�.� : � � , .,� , �� � , . .v..;,���,�.- ,� �;. � ; �i^ � '� t4 °� ��. � � ,� ,�s� �} .�' �� a� . , � e � -� �V $� � .e.,� ,��. dv�. � ��0 ._ � , -W�' -f� ��_ �:'�e �� ` . � _ ` : 2 . . ,� ' +� - ii'"��,�,t. F t ' _f, d y x" � � Y'%T.s '"° � r.rn•.'G� .�.:- . ` ' . �-.. . . ... g� . � - ���,�„ � r e„� t`. ..,,w ',- .... ... ,jf :. q� —✓��• �.. "`..'`K 'h�`��,tr` '�'�'�d^W:v.,., � d ' ��„��� u�j'� ry� �t � � � .n � r� J, � , �� f ..� .���� � � �J 'Qf � 4 „�; c, •s�!. ,�,,. .},.� " � 1 '9 ' '�` V���`^ r� fi• °�i .y�' �, vye+Ry�.`�"�' � � t.i �7'� �. 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