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Home My WebLink About2014-00918 - sewer/water pass through fees , CITY OF ORONO *��J 1 4 — (d 0 9 1 8 * . 2750 KELLEY PARKWAY DATE ISSUED: 08/19/2014 � 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 : PASS THROUGH FEES N OTE: PAID VIA: CK#2451}'OR$2712.00 FOR THE SEWER&WATER PASS THROiJGH FEES&CK#2451$2485.00 FOR THE SAC CHARGES. APPLICANT SEWER CONNECTION CHARGE- WAYZATA 590.00 WATER CONNECT]ON CHARGE- WAYZATA 2,122.00 HARTMAN, TODD S.A.C. 2,485.00 60 MYRTLEWOOD RD WAYZATA, MN 55391- TOTAL 5,197.00 � Payment(s) CHECK 2451 5,197.00 OWNER HARTMAN, TODD 60 MYRTLEWOOD RD WAYZATA, MN 55391- AGREEMENT AND SWORN STATEMENT The work f�or which Ihis permit is issucd shall be performed according to the approved plans and specitications,applicable City approvals,and the State Building Code. This permit is for onl��the work described and does not grant permission lor additional or related work which requires scparate permits. All provisions of laws and ordinances goveming this rype of work shall be compied with whether or not specilied herein This permit will expire and become null and void if�construction authorized is not commenced within 180 days of the da[e of issuance,or if construction is suspended for a period of 180 days at any time atter work has commenced. The applicant is responsible for assuring all required inspections are requested in confomiance with the State Building Code.This permit may be revoked at any time for due cause. \ Lv / � / / pp ieant Permj ee Signature Date Issued By �gnature ,,L„� Date / O\ City oi Urono 2750 Kelley Parkway Orono MN 55356 g52-249-4600 Receipt No: 3.011598 Auy 19, 2U14 Todd Hartman .00 Previous Balance: Permits 590.OU 2014-00918 60 Myrtlewood Rd 101-20807 Wayzata Wtr/Swr Connection Fee Permits 2,�22.U0 2014-00918 60 Myrtlewood Rd 101-20807 Wayzata Wtr/Swr Connection Fee per mi ts 2,485.0(1 2014-00918 60 Myrtlewood Rd 101-20809 SAC Charges due to MWCC _ 5,197.00 Total: _______________ Check 5,197.00 Check No: 2451 Payor: Todd Hartman 5 197,00 Total Applied: ___________ .00 Change Tendered: 'V__i_ ________ 08/19/2014 04:42PM � ! �.,—�-� FOR CITY USE ONLY j`^g'�'�� Clty Of OCOriO Date Received: Permit# / M1� P.O.Box 66 ` 2750 Kelley Parkway ❑In-House SAC Dete�mination Form Completed ��,�� ' Crystal Bay,MN 55323 ''�� (952)249-4600 Approved By(If Required): xr„ CITY OF ORONO—HOMEOWNER SUPPLEMENTAL FORM WAYZATA- SEWER& WATER PASS THROUGH CONNECTION FEES & SAC FEES (ALL PERMITS-Mav be subiect to further review and mav not be issued when the auplication is received) PERMIT CODES(IN-HOUSE) Sewer�Residential/Pass Through Fees!Blank Water Residential/Pass Through Fees/Blank Sewer&Water/Residential/Pass Through Fees/Blank GENERAL 1NFORMATION 1. SAC& SEWER&WATER CONNECTION FEES CAN'T BE PREPAID—UNLESS THE CONTRACTOR WILL BE PULLING THE PERMIT IN A FEW DAYS. (PER MET COUNCIL). 2. If payments are made: Prior to the actual sewer or water connection permit(pulled by the contractor)the payment will be held until that permit is received and paid for. 3. These payments can only be made with check or cash,because they are pass through fees. 4. If you the homeowner wants proof of this payment,we will hand write a payment receipt. 5. We will not hold this payment more than a few days to one week,at which time if the contractor does not come in we could reserve the right to return your check to you,or collect additional fees that could change. 6. Once the sewer or water connection permit is issued,we will issue this permit and send you the homeowner a copy. TYPE OF PERMIT (Check All That Apply) �Residential(May Require Approval) �New Connection ❑ Water Availability Connection For Future Hook-Up to Water Job Site/Owner Information: Site Address: � � i'l.� Iti-0 �' G �2 � Owner: � ° � �� '' � � � �'`"��`'` Mailing Address: �S" �- ��'`�� city: �U � �� ,�- zip: �� 3 `t l �' I � � ��7 �" � � �� `� 1 Home Phone: Alternate Phone: r DETERMINING PERMIT FEES � SAC Charge(2014 Rate=$2,485.00) $ (SAC Charge must accompany all sewer permit applications unless prepaid) (Orono Ciry Staff can determine if applicable) (If not prepaid, a sewer connection permit will not be issued) .�] Sewer Connection Charge—City of Wayzata(Pass Through Fee) $ (2013 Rate=$590.00) � Water Connection Charge—City of Wayzata(Pass Through Fee) $ (2013 Rate-$2,122.00) ❑ Water Connection Opt-Out—(Please Initial) I am choosing not to hook-un to water at this time. ❑ Water Availability— (Please Initial) I am choosing not to hook-up to water at this time. I have chosen to have my contractor make it water available for future hook-up. Water Availability 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: 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 TOTAL PERMIT FEE(Add Fees Listed Above) $ � � � � � � ADDITIONAL 1NFORMATION—WATER METERS ■ WATER METERS must be picked up and paid for at Orono City Hall, these are on a separate permit. Typically the contractor will pick-up and pay for this 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 conect. � � � l � � I � �� Owner: Date: f