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Home My WebLink About2009-00847 - sewer connection � '� CITY OF ORONO PERMIT NO.: 2009-00847 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUEn: 1U25/2009 952 249-4600 FAX: 952 249-4616 ADDRESS : 30 MYRTLEWOOD RD PIN : 36-118-23-33-0011 LEGAL DESC : MYRTLEWOOD : LOT 003 BLOCK 001 PERMIT TYPE : SEWER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : CONNECT[ON NOTE: SAC AND WAYZATA SEWER CONNECTION CHARGE PAID BY HOMEOWNER ON CHECK#4731 PERMIT#2009-00846 ��,�0G�1 APPLICANT `'`'"c� e f vct�tc� �� , "� 50.00 COPPIN WATER& SEWER SEWER CONNECTION CHARGE-WAYZATA 50.00 864 QUAIL PKWY WATERTOWN,MN 55388- STATE SURCHARGE SEWER& WATER 0.50 TOTAL 100.50 OWNER PAULSON, BRUCE& LORI 30 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 Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires sepazate 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 180 days of the date of issuance,or if cons[ruction is suspended for a period of 180 days at any time after work has commenced. The applicant is cesponsible 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. �o; <_. Gr �-� 1 l��1� l l App�cant Permi e Signature ate Issued By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. � ' FO�SE��NLY �,¢0�� City of Orono DateReceiuedf� Gt Permi�#��" ��7 P.O.Box 66 ' T� 2750 Kelley Parkway ❑In-House SAC Deteimination Fmm ComQleted ' � � ,, � Crystal Bay,MN 55323 �o� (952)249-4600 Approued$y(If Required): 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 aoalication is receivedl GENERAL.Il�TFQI�MATTON ' 1. You may apply for urility permits by mail or in person at the City offices. 2. Mailed in applicarions 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. Urility connecrion pemuts 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 egpress approval of the Public Works Department. Issuance of a perxnit 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 PERIVIIT "= (Check`All That A 1 �:. ; �Residential(May Require Approval) ❑ Commercial(Approval Required) �New Connection ❑Additional Connection ❑Re-Connecrion ❑Repairs ❑Disconnect ❑ Water Availability Connection For Future Hook-Up to Water Joli Site/Owner Information: Site Address: �d NL.,��_(T�� i�C Owner:(tii�r/L��;��c n,� Mailing Address: �r� �1 City: or,�n�� Zip: Home Phone: 95u��y7`�••0�� Alternate Phone: �Sdd-��7��`� Contraetor information: : Contractor: �•c�,�p,` ��,L�,-e,�,�te( Contact Person: (��+-1 � Address: �b�{ C�.,,r�;.� �� State License#: �7�,o�,o -�'�'1 rL City: Wct,{C(.I��,�n _ Zip:5�3� Expiration Date: 1 a -��- � ¢ Phone: `�5� `�S��-l5�4� Alternate Phone: �,�o�,- S n�. ��;C� ,,�' �� `�� DETERMINING PERMIT FEES �� I ❑ SAC Charge(2009 Rate=$2,000.00) $ (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) $ �Q,p�_ Pipe size �_�/C�. _inches;material�Schd 40 air tested; cast iron �.Y ,�Water Connection/Disconnect/Repair($50.00/Per Stub) $ ��,�� Pipe size 1�� inches; material�Schd 40 air tested; copper L�-� f�'a� �f ❑ Water Availability For Future Hook-Up to Water($50.00) $ C� 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 Connection Fees Paid(If Applicable) Issue Water Connecrion Permit: 1. Collect Pernut Fee&Issue Water Connection Pernut 1. SUBTOTAL of Permit Requested: $��, 2. STATE SURCHARGE $ .50 3. POSTAGE&HANDLING(Only on Mail-In Applirations) $ 2.00 4. TOTAL PERMIT FEE (Add Lines 1-3 Above) $ Q �,�� ADDITIONAL INFORMATION—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 instailation. 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,tn;e and correct. Applicant: ��,,�� 1��„t� Date: t I� o�,_.�- G 9 -�a � � ✓ l� � �-J �' A TIME � �•�✓� " CITY OF ORONO CALLED IN 9 INSPECTION OTICE CHEDULED � PERMIT NO. '�� COMPLETED ADDRESS � OWNER ONTR. TELEPHONE NO. � � / —SDg� � DESCRIPTION ��`'�K � ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORENVEfLANDS y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q p FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. � ❑ COMPLAINT � ❑ DEMO-FINAL ❑ SEPTIC INSTAIL. ❑ FOLLOW-UP _ ❑ PLUMBING RI ❑ SEPTIC FINAI. ❑ WARD COVER REMOVAL J ❑ PLUMBING FINAL ❑ FOUNDATIOWREMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO v�, COMMENTS: � 1✓v�l �-� � a ;,�f �c�l�� S �%S r?�� l� � f�zc�xt�.t� o `Z�� L I C�� 10 E 1"�L�..s� i� a � ° 7 P f3c�.' l-� � f �l S -t- � i 1 es T�_� r pu,c� � S�_ Q ��l� .s�� Sf��r.� �i �� 5 z Lr� �2,� CJ r�ti� �►.� c� �� C�F��d�r W � W � � �ORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE R � W O CORRECT WORK 8�PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHiN HOURS. p pHOTOTAKEN INSPECTOR WFLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED �INSPECTION RE�UIRED.CALL TO ARRANGE ACCESS. Ca11 for the next inspection 2a hours in advance. (952) 249-4600 Owner►Contractor site: �� . , Inspector. �l s White CopyllnspectoY's File Canary Copy/Slte Notke