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Home My WebLink About2012-00295 - water pass through fees CITYOFORONO * Z012 - 00295 * • 2750 KELLEY PARKWAY DATE ISSUED: 04/18/2012 � ORONO, MN 55356- 952 249-4600 FAX: 952 249-4616 ADDRESS : 70 MYRTLEWOOD RD PIN : 36-118-23-33-0018 LEGAL DESC : REG. LAND SURVEY NO. 0446 : LOT 000 BLOCK 000 '�' � � �•�� .� �3�t; i��e�iey P�rlw�p PERMIT TYPE : WATER �p� � �5� , jG;_ �;_-��Esv_: PROPERTY TYPE : RESIDENTIAL ��1 � �� .�� , - CONSTRUCTION TYPE : PASS THROUGH FEES � � #�s's NOTE: THIS IS THE WATER CONNECTION FEE FOR PERMIT# SEWER CONNECTION&SAC WAS ON PGRMIT# P�evi4Us.balaYrcg; ^, ,�� QLri[k�5 7fJ Myrtlewwa',d �d` Da�S ' :�,lc�.t�' PAID VIA:CK#125 ZOE SWANSON ��,�� F�, a , 1�I-�,48Ui l��yzata Nti�?Swr`Ca�nneetio�r:!�ee ,�'sal; --- �"�,ti�2.[�ti t _��r.. -�c !�lo: IiS, , . ` 2f'�22.#�D �f: �:�'!.�i1�UR Nr�p��: �,��v i.� � h.r:u;Y-w_w ��ldtt�p iEt1{ik1"E�: " •,-'�� ¢ --a��z v. �F�?8��i4 1`�;;.�i.r�, , APPLICANT WATER CONNECT[ON CHARGE-WAYZATA 2,122.00 SWANSON, JOSEPH TOTAL 2,122.00 70 MYRTLEWOOD RD WAYZATA, MN 55391- OWNER SWANSON,JOSEPH 70 MYRTLEWOOD RD WAYZATA, MN 55391- AGREEME1vT 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 separate pemiits. 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 construction is suspended for a period of 180 days at any time afrer 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. il� i � i l Applic Permitee Signature Date Issued By nature te SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB . v� �� i �ox crr�:us�o�v��r ,¢�� City of Orono I�ateRar.eiv�i: Pemut# � �� 0. Q P.O.Box 66 ;��, �, ;: 2750 Kelley Parkway �Tri C�?o�se SAC Det�nxtu�a6Qn�'ortn Cc�mpl�ted, �' Crystal Bay,MN 55323 � �" � � � � ,�a�.�a� (952)249-4600 Approved�3y(If Aequired): CITY OF ORONO—HOMEOWNER SUPPLEMENTAL FORM WAYZATA- SEWER&WATER PASS THROUGH CONNECTION FEES& SAC FEES (ALL PERMTTS-Mav be subiect to further review and mav not be issued when the aaalication is receivedl PERMIT CODES(IN-HOUSE) Sewer/Residential/Pass Through Fees/Blank Wated Residential/Pass Through Fees/Blank Sewer&Water/Residential/Pass Through Fees/Blank �ENERAL I'i'�TF��tMATI�I�T 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. TI�'PE OF FERI�IT (Gheek A11 That�A 1 } �r Residential(May Require Approval) ❑ New Connection ❑ Water Availability Connection For Future Hook-Up to Water Job Site/��mer Irifor.�iat�on: i Site Address: � �, �KK�S+-I�XSoc�. ��-d- SS 3� ( Owner��2�n Su�G..n Sc+rl Mailing Address: � c�ty: C�Rono � v�Sa�.eza�-o� zip: 5 S3°�) Home Phone: °t52-23�1- �Z2s Alternate Phone: q52-23a-��D� 1 ❑ SAC Charge(2012 Rate=$2,365.00) $ (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 Charge—City of Wayzata(Pass Through Fee) $ (2012 Rate=$590.00) � Water Connection Charge—City of Wayzata(Pass T'hrough Fee) $ � �,� ' v � (2012 Rate-$Z,122.00) ❑ Water Connection Opt-Out—(Please Initial) I am choosing not to hook-up 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 Availabilitv Exalanation: 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) $ c? ! a 2• !� (7 AI�DITIUI�t�I.,INFOR:IVIA.'I'T�i�=i�AT�R 1�1ETE�S ■ 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 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,true and correct. Owner: Date: L}� �arJZ