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Home My WebLink About2015-00505 - sewer connect . • CITY OF ORONO * Z 0 1 5 — 0 0 5 0 5 * 2750 KELLEY PARKWAY DATE ISSUED: 04/29/2015 ORONO, MN 55356- 952 249-4600 FAX: 952 249-4616 ADDRESS : 1575 MAPLE PL PIN : 08-117-23-33-0032 LEGAL DESC : CRYSTAL BAY VIEW : LOT O10 BLOCK 006 PERMIT TYPE : SEWER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : CONNECTION NOTE: NEW SEWER CONNECTION APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 STATE SURCHARGE SEWER&WATER 5.00 J P SCHMITZ CONSTRUCTION COMPANY LL TOTAL 55.00 16450 117TH AVE N Payment(s) MAPLE GROVE,MN 55369- CHECK 2528 55.00 OWNER Atlas Homes 14450 117TH AVE N DAYTON,MN 55369- 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 permi[s. 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 afrer work has commenced. The applicant is responsible for assuring all required inspections are requested in conf ce with the State Building Code.This permit may be revoked at any ' e r c�e�use. , r /,,- , � `� � ic1 i 5 plicant Permit�.S}gnature Date Iss By Signature Date f - F� CITl U}5E ONLY �� Q�-U1,I�� City Of OrOno Date Received Permit# ot�/5 '� P.O.Box 66 �� l �! 2750 Kelley Pazkway ❑In-House SAC Determination Form Completed � f`'�y\, � �% Crystal Bay,MN 55323 � \��+�IiSH.��/' (952)249-4600/Fax(952)249-4616 Approved By(ffReqaired): �,J ��____., CITY OF ORONO—SEWER& WATER/GENERAL PERMIT (*Note:Some permits may require approval by the Building Official and/or Public Works Department*) (ALL PERMIT5- Mav be subiect to further review and mav not be issued when the aaolication 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 permit card is available on the job site. 5. Utility connection permits may be issued to licensed contractors only. 6. Contact the Public Warks 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 accardance with State Code requirements. 8. All wark must be inspected before it is covered. Call(952)249-4600,24+hour notice required. TYPE OF PERMIT (Check All That A ly) �Residential(May Require Approval) ❑ Commercial(Approval Required) / � New Connection ❑ Additionai Connection ❑ Re-Connection ❑ Repairs ❑Disconnect ❑ Water Availability Connection For Future Hook-Up to Water Job Site/Owner Information: Site Address: /�� /V�TC/✓� Owner: ��r'�� I��fv Mailing Address: City: Zip: Home Phone: Alternate Phone: Contractor Information: .-� � � 1 Contractor: �1 � f • ��L��Contact Person: ��'� U / �i Address: ��j7�� 17��Y�/� State License #: �,� i � City: ��`� �'��Z� Zip�'7�� Expiration Date: Z l� Phone: �6J/ ��'Z/ �`�� Alternate Phone: �C/� �U�✓` l �� DETERMINING PERMIT FEES ❑ SAC Charge(2015 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) �ewer 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 Exnlanation: Contractor installed line to inside of house for future hook-up. This line will be inspected by the Public Works Department. Rec�uired Before Water Connection Permit is Issued: L 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 for at Orono City Hall,these are on a senarate�ermit. ■ 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 certifi at all s �s made on this application are,true and correct. ,�'' i ,,; __ Applicant: Date: G ` �.�v`�"�' DATE TIM� CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED PERMIT NO. �n/��5 COMPLETED ADDRESS l S `-T S ,Y1/��1�le P � OWNER TELEPHONE NO. CONTRACTOR � �C�I/►�J�l�'�z-- � DESCRIPTION ��r COYI{�`Q�,-{�'a{/1 W ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ 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 _ ❑ AS BUILT-SURVEY �SEWER HOOK-UP ❑ FOUNDATION/REMOVAL v ❑ DEMO-SITE ❑ SE TIC INSTALL � OWNERICONTRACTOR TO MEET YOU:�YES_NO v�i COMMENTS:�� - / � ��1�� %/.J �7`r�� 'J c�� o5�=,,w��- �-�vi�' � 7� .Sc�t��- ,� .�-i � �. � ° �{ �� S<<i y�;� m v� S�wc9- s��,-vi a'Q W � Q Z _ 7 � �/ �' �E'S� ��' � h�ie✓fi,�-P !�/¢� w /'� • � J � /C�WORKSATISFACTORY:PROCEED ' 1 PROJECT COMPLEfE W� ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN INSPECTOR WILL REfURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in a�vance. (g52) 249-460� OwnerlContractor on site: �� `� h.-,�� Inspector. -Sc� White Copyllnspector's Ffle Canary CopylSite Notice