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Home My WebLink About2014-00923 - sewer & water connection CITY OF ORONO * z 0 1 4 - 0 PJ 9 2 3 * 2750 KELLEY PARKWAY DATE ISSUED: 08/20/2014 ' � ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 60 MYRTLEWOOD RD PIN : 36-118-23-33-0020 LEGAL DESC : REG. LAND SURVEY NO. 0446 : LOT 000 BLOCK 000 PERMIT TYPE : SEWER&WATER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : CONNECTION NOTE: SAC PD ON PERMIT 2014-00918 APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 WATER CONNECT/DISCONNECT/REPAIR 50.00 KOTHRADE SEWER&WATER STATE SURCHARGE SEWER&WATER 5.00 12059 WHITETAIL AVENUE HANOVER, MN 55341 TOTAL 105.00 �� Payment(s) Minnesota State License#: SW-192 MPCA CHECK 18821 105.00 OWNER HARTMAN,TODD 60 MYRTLEWOOD RD WAYZATA,MN 55391- AGREEMENT AND SWORN STATEMENT The work for which[his 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 permits. All provisions of laws and ordinances goveming this type of work shall be compied with whether or not specified herein.This permit will e e and become null and void if construction authorized is not om nced within 180 days of the date of issuance,or if construction is uspen ed for a period of l SO days at any time after work has commenced. he ap lic t is responsible for assuring all required inspections aze r quest d i nforman e with the St te Building Code.This permit may be voke at i e for e cause. � / / Ap licant Permite ignature ate Issued By Si ature Date (�� I - O FOR CITY USE ONLY ' �L- /�l�� City of Orono Date Received: Permit# r P.O.Box 66 �� 2750 Kelley Parkway ❑In-House SAC Determination Form Completed �� ' Crystal Bay,MN 55323 l"� < (952)249-4600/Fax(952)249-4616 Approved By(If Required): ., -,"�K��s t�c�r�/ 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 aonlication 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. 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 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 ❑Additiona(Connection ❑Re-Connection ❑Repairs ❑ Disconnect ❑ Water Availability Connection For Future Hook-Up to Water Job Site/Owner Information: Site Address: �U ��`� �+(�" ' � r�D� � �� Owner: G�(T�"►',Gt✓� Mailing Address: S I`�� City: V`�0✓�U Zip: S_`�.3�l � Home Phone: �? E Z ' S I `� ' Z Z`� � Alternate Phone: Contractor Information: .� Contractor: ��t'�nf,;,��ua��o�-� Contact Person: �avh ��r,�.Z- �r Cxcc.Je-k;r� , Inc� Address: �zo�'�� ,�,;�-e.�,�1 L�� State License#: � City: v`� Zip:� Expiration Date: Phone: �j��/�?g" �d�G '- Alternate Phone: ❑SAC Charge(2014 Rate=$2,485.00) $ (SAC Charge must accompany all sewer permit applications unless prepaid) (Orono City Staffcan determine if applicable) (If not prepaid,a sewer connection permit will not be issued) �Sewer Connection/Disconnect/Repair($50.00/Per Stub) $ 5� Pipe size inches;material Schd 40 air tested; cast iron �Water Connection/Disconnect/Repair($50.00/Per Stub) $_�V Pipe size inches;material Schd 40 air tested; copper ❑Water Availability For Future Aook-Up to Water($50.00) $ Water Availabilitv Exalanation: Contractor installed line to inside of house for futwe 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) $ � �� _, ":_,' A;�?�7�`TT{�1��I:��N'FO��VIt��tJ�"=�'`�V�`�,1'�I,��'�"�JRS . : '; 4�4: ■ WATER METERS must be picked up and paid for at Orono City Hail,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 undersi ed reby applies to the City of Orono for issuance of a Utility Permit,agrees to do all work in rict cco dance with the ordin ces of the City and the regulations of the State of Minnesota, d c ifi all s ements de on this application aze,true and correct. R �� Applicant: Date: �� D TIME V CITY OF ORONO CALLED IN � �� INSPECTION N TIC SCHEDULED �� P�RMIT NO. ��'� '�� COMPLEfED ADDRESS 6 D �� OWNER �/YG�/ TELEPHONE N0.7�03 �� 87 d 2— CONTRACTOR L 1�h�'a�.Q S �' �; DESCRIPTION S�� ' �� l� � W ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING � ❑ POURED WALL � MECHANICAL RI ❑ LAKESHORE/WETLANDS � Q ❑ 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 ❑ SEPTIC MAINT. ❑ FOLLOW-UP ? ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL ��YYNERICONTRACTOR TO MEET YOU:_YES_NO c�.� COMMENTS: / � `�" � a i� i� � t� �9/ .�� 0 � �L�C2 o � � /�� W � � z �'� � S'�,��'��C_.__ ��' C � , °.r W - r � � . � � < - J �r�ORKSATISFACTORY:PROC ED ❑ PROJECTCOMPLEfE W RRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WILL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 2a hours in advance. (g52) 249-46�� OwnerfContracto n site:��,��4 d� Inspector. � � White Copyllnspector's File Canary CopylSite Notice