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HomeMy WebLinkAbout2013-00110 - sewer disconnect -. CITY OF ORONO * 2 0 1 3 - 0 0 1 1 0 * 4 2750 KELLEY PARKWAY DATE ISSUED: 02/19/2013 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 1545 MAPLE PL PIN . 08-117-23-33-0029 LEGAL DESC : CRYSTAL BAY VIEW : LOT 007 BLOCK 006 PERMIT TYPE : SEWER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : DISCONNECTION NOTC: SEWGR DISCONNI?CT ONLY APNLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 DEAN JOHNSON HOMES, INC. STATE SURCHARGE SEWER& WATER 5.00 4700 CTY ROAD 19 MEDINA, MN 55357- TOTAL 55.00 (763)479-4820 Minnesota State License#: 20639439 OWIYER Maple Place LLC 550 25TH AVE N ST. CLOUD, MN 56303- AGREEMENT AND SWORN STATEMENT The w°ork for which this permit is issucd shall be performed accordinc to the approvcd plans and specitications,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 governing this type of work shall be compicd 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 conformance with the State Building Code.This permit may be revoked at any time for due cause. ��� ,-�-.-_�-F-' l_ �c� ��� / (�7 /��-�� „ \ / ,�,'�- " � / ` / � '� .. �c C:�''7� i� s"� / / ApplicantPermitee Signature Date Issued By, ignature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. � i i ,r• , f F� ,�;�'S� 1 �I�ddd� �a.. �����;,` I ��ICity of Orono ��1� � x W;��FgM � , ,�-� I � ������ LL��S —�,�TQl���,� P.O.BOx 66 :,, '�a � �� '����I���+9r��F�3Y�'t t �''��6ug�' . i 2750 Kelley Parkway ��]yl�'h']fi���f������t1�d�iY�t�i�f.L�l'f��t�4i '' ' {` Crysta!Bay MN 55323 z� ��R����'i5�'+��'i ''�r" 8��, °E �,i,,,,�a a : y���d•es on�`, �952)249-4fi00 ;'��1�te�k����"������ , �,,./� i:3"'?ir��:°u�'.�xh�m�°v.�i�3'i'i.s"s.nir�vinii°�ii'�'iu iuvewMxi� e � .��_e•i.....3�,�;•; CITY OF ORONO—SEWER& WATER/GENERAL PERNIIT (*Note:Some permits may requiro approval by the Building Official and/or Public Works Department•) (ALL PEI2NIITS- Mav be aublect tQ further�Ysw end mav not be issued wdea the ennllcation ia receivedl . . ,.. . . ° • "_� �� r�.� � � ii i3 i°�,Yr4 �"" T:� 3 +Y „ :,��'�� r �,..:. "�Qi@;• � _�''€'3� -:....�..�. . . ' .n�us: �n . ........ ����.i.�....�.::.. H..;.,:.:�;u�:=:`y - :. , . 1. You may apply for utility permits by mail or in person at the City offices. 2. Maiied in applications are subject to the postage and hand.ling 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. Urility connection permits may be issued to licensed contractors only. 6. Contact the Public Works Department(952-249-4600)for utility atub as-built locations. DO NOT EXCAVATE IN ANY STR�ET AND DO NOT TAP ANY MAIN without expreas approval of the Public Works Department. Issuance of a permit does not grant this approval. 7. All work mnst be done in accordance with State Code requirements. 8. All work must be inspected before it is covered. Call(952)249-4600,24+hoar�aotice required. _ � � q { .0 : �>�,�t�`YS"4 yl� € 4 � � p , ' f r 3� s �.�s� ,�r�,a�����3u� � i�� ��� a�- h � � �.n a��� I w��S 3 ��a..k a r� � ��. �5 t e��+u ueu a - � f . SFc �� :. x�`� �. ' '���� �u x � '�m�, � z .�,g s�aq �, '��_r��;,r�, h��,; .. � ..-',��,__ .''�� �. N4 r� .�,� .. . .. .......__ _ - -- �....._... . . ....... . nz........_ �p� �Residential(May Requ've Approval) ❑Commercial{Approval Required} ❑ New Connection ❑Addirional.Connection ❑Re-Connection ❑Repairs �Disconnect ❑ Water Availability Connection For Future Hook-Up to Wate �s .a �i+..x . � ya� �: � +�!.Mien � �������! 3 , ��s�i Site Address; 1 S�S r'1�,0�. ��p„c.� Owner: �l���ou� . 1^� Mailing Addxess: City: Zip: Home Phone: Alternate Phone: ����'�� ���s�iQ�� ' � � �, • 0 Contractor: ��„���v�ca,�, I�m.,� Contact Person: �� Address: �l�oo �,�, 1Z� Iq Sta.te License#: �(.o���_ City: Ma,B,�.�.e,.. Zip:5535,Expiration Date: _ 3�3�l�_ Phone: Z(,p�—�'iQ- ��Z�U Alternate Fhone: ��*T��v— Z4Z—?rv' Q ( . ' ❑SAC Charge(2013 Rate=$2,435.00} $ (SAC Charge must accompany all sewer permit applications unless prepaid) (Orono City Staff can determine if applicable) (I[not prepaid,a sewer connection permit will not be issued) ❑Sewer Connection/Discoanect!Repair($50.00/Per Stub) S Pipe size inches;material Schd 40 air tested; cast iron ❑Water Connection/Disconnect/Repair($50.00/Per Stub) $ �O. OU Pipe size inches;material Schd 40 air tested; copper ❑Water Availability For Fature Hook-Up to Water($50.00) $ Water Availabilitv Exalanation: Contractor installed line to inside of house for future hook-up: This line will be inspected by the Public Worics Departmant. 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: $ � Q. O� 2, STATE SURCHARGE $ 5.00 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PE:RMIT FEE(Add Lines I-3 Above) $ �J rJ . C� C� .4' .. s d f - ��*'[� � - .0 3 � _ ��:���:�����: ., . . ����,�.�.�...,._. �,�`,5_� � '� `; . __. ,_,��. ,:�..._........,._ _ ..._ r - ■ WATER METERS mast Ue picked up and paid for at Orono City Hall,these are on a s�arate permit. • WATER METERS musf be set and sealed by Orono Water Department (952) 249-4604, upon completion of rneter insta[lation. The undarsigned hereby applies to the City of Orono for issuance of a Utility Permit,a.grees to do all work iii sirict accordAnce with the ordinances of the City and the regulations of the State of Minnesota,and cartifies that all statements made on this application a.re,true aaid correct. t�pplicant•. `�— �. ��n,�..__ Date• �-- � � b � � � DATE TIME ✓ CITY OF��ONO CALLED IN o? � INSPECTION TICE � / SCHEDULED �-S�3 PERIUIIT NO. �`�-�!`�7 COMPLETED ADDRESS �J��S �G�-�l� P"��t� -. OWNER ELEPHONE NO. � CONTRACTOR � ��= �C�_ ' �; DESCRIPTION ��'L''P�-- �SC�YC���� � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y � FRAMING ❑ MECHANICAL FINAL Q ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL Q OWNERICONTRACTOR TO MEET YOU:_YES_NO � � COMMENTS: � � CG9���"t:'<v �� �� �'��>� � � �� �7L� 5 _ 1�/ � /� j O � � O � W � Q ti 2 W � W � � d W WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR W{LL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTfON REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� 249-4600' OwnerlContractor on site: �`JrS��:r��i'� ��-�`�� ��°�'�✓"'i `y��i�� Inspector. �Cz: � White Copyllnspector's File Canary CopylSite Notice ��.',� � ''1"`�:'"� �" �+� �„ t� "'�4 'E Si �*t�y�� r���rti � �s r �� �� �� x,•��`�+ "� n �y i�f�,'-' ��5�����".���`#'� �, "��' � ��a�. � �i�,. 4 w. �� #�c��,� � �.� h, .��" '`-�' � Lr X � T i'#',,d�i '�,^-,r' 'w ��l � w � n a. ���,q�� +4�'���.. M'^ "�� ` .. '` ' �• "'"�M .�s f ' ' � � � - - a-A ��� k� + ~ r ��i .,. + ii'i� . 54'�. a .. � ,�i � d > � '.e � . .. d' . -�7 �y.��t.y� '���t .�3. � • , : .; '1 � �� e� _ ., �, - t �'� -. �� ~ �*��� �t� Ty .a��+�.' ._ , � ���- .��� � �c t�a;•�,� .� �� �-�`�,;;�y� ' �. �� � &� � �`�r. ��� . �. �. �f' 'e$ 'iy I . . �����17 . ,�� � � �. � � �( ��� � +! 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