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Home My WebLink About2010-00817 - sewer connection � CITY OF ORONO rEaM�T�ro.: Zoiaoosi� � 2750 KELLEY PARKWAY ORONO, MN 55356- DATE lss[1En: 09/10/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 20 MYRTLEWOOD RD PIN : 36-118-23-33-0010 LEGAL DESC : MYRTLEWOOD : LOT 002 BLOCK 001 PERMIT TYPE : SEWER PROPERTY TYPE : RES(DENTIAL CONSTRUCTION TYPE : CONNECTION NO"CE: SAC WAS PAID&WATER PASS THROUGH FEE PAID ON PERMIT#2010-00797 09/03/10 BY:HOMEOWNER. APPLICANT SEWER CONNECT/DISCONNECT/REPA[R 50.00 COPPIN WATER& SEWER STATE SURCHARGE SEWER& WATER 5.00 864 QUAIL PKWY WATERTOWN, MN 55388- WATER AVAILABILITY 50.00 TOTAL 105.00 OWNER BOVEE, PETER 20 MYRTLEWOOD RD WAYZATA, MN 55391- 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 Quilding 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 compied with whe[her 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 af�er 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. �L.J � � `� i l� i _n�T� � c ��yr��.� l~ ��' -�c;% � �^�� . i i App icant Permite Signature Date Issued By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. � t � S g g S S 8 8 � � � � � o � � � .� � � � � � � �� o � � � �� . � � � � � � � � o �a� S -� �� o �- � � � , � ` �� $ � � b �� ^ � � � g � � o�° '� � +•�u �°, �� .. •� �� i ��'�' C"'� `�o � ''c ��"'+�-� F— �,i, � " �.. --� �� c3 c�cu� d� c� c�'�4i'�'��c�.�i��a��l'i'��S o '�i a .S � �-- �- �f5 FOR CITY USE ONLY ,��,�` City of Orono Date Received: Permit# O `rO P•O.Box 66 �; 2750 Kelley Parkway ❑In-House SAC Determination Form Completed a '� ?,. �t. p, Crystal Bay,MN 55323 �'t'��go�Oe (952)249-4600 Approved By(If Required): 4 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 a�plication is received) 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. Pernut 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 pemut card is available on the job site. 5. Utility connection pernuts 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 pemrit 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 Apply) � �� ❑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: c�f; ./V� y(`��{� w,�� Owner: �C'_��_��{;U : � Mailing Address: o�D !►'� �'r-�Ic� ;�;r,f,�l 4�t� City: d�0 I� �,a Zip: Home Phone: q S�.��I 7 3 7°13 7 Alternate Phone: Contractor'Information: Contractor. ��;r� ��ui��, �,.,«le< Contact Person: �`I,l ' ,o,�;,� Address: �(�`-� �;��c�: � ,��..� State License #: ��)aay'/�'l 1� City: �,��,,�Q('�� Zip:�3�, Expiration Date: �o� � � 1— � l� Phone: �I Sa-`�SS"(5 � Alternate Phone: V �a " �p� "'��7C.# A �^ A ... .. .., . DETERMINING� E ' e ��, �� , �� . ,� .�. .. �� ., � .��. _,.>.E.�< �,.w;a ❑ SAC Charge(2010 Rate=$2,100.00) $ (SAC Charge must accompany all sewer pernut 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 mches;material Schd 40 air tested; copper ,�Water Availability For Future Hook-Up to Water($50.00) $ r � 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: L Issue Water Meter&Horn Permit 2. Any Additional Connecrion Fees Paid(If Applicable) Issue Water Connection Permit: 1. Collect Permit Fee&Issue Water Connection Permit 1. SUBTOTAL of Pernut 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 1NFORMATION—WATER METERS ■ WATER METERS must be picked up and paid for at Orono City Hall, these are on a separate 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 work in strict accardance 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: �'LC.� �,-✓ Date: I —l C, � l.� 1�--3 �� ✓ �ll E �O TIME CITY OF ORONO CALLED IN � INSPECTION NOTICE ��.'� SCHEDULED � � �� PERMITNO. ��"� COMPLETED ADDRESS aU � /� OWNER T LEPHONE NO. I �1'SOS- g� ` � ►� N -s i � t CONTRACTOR �; DESCRIPTION ��J�i��v` a �W'P� � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL � MECHANICAL RI ❑ LAKESHORE/WETLANDS 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 J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP i ❑ DEMO-FINAL ❑ SEPTIC INSTA�L � HARD COVER REMOVAL v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO y COMMENTS: � W o_ � �iZe�'—� � �� S�, �3 .�ii� -�'-�'� 0 � Q �< SS��Q S , Z Q��,��+ c,��q � W � W � � W RKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE � ❑ ORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT O CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WlLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (J52� 249-4600 OwnerlContractor on site: Inspector. �'lT.�,�� White Copyllnspector's File Canary CopylSite Notice