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Home My WebLink About2014-00081 - new sewer connect � �. CITY OF ORONO * 2 0 1 4 - 0 0 0 B i * 2750 KELLEY PARKWAY DATE ISSUED: O1/27/2014 ORONO, MN 55356- 952 249-4600 FAX: 952) 249-4616 ADDRESS : 1376 NORTH ARM DR PIN : 07-117-23-41-0052 LEGAL DESC : SAGA HILL REVISED : LOT 000 BLOCK 008 PERMIT TYPE : SEWER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : CONNECTION NOTE: NEW SEWER CONNECTION APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 STATE SURCHARGE SEWER&WATER 5.00 MINNESOTA DIRTWORKS MAIL-IN FEE 2.00 2500 W CTY ROAD 42 SUITE#105 TOTAL 57.00 BURNSVILLE, MN 55337- Payment(s) CREDIT CARD 5144 57.00 OWNER BOWEN, WILLIAM 1376 NORTH ARM DR MOiJND,MN 55364- 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 dces 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 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 after 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. � Z7 / � °��T App ' ant Permitee Sig ure ate Is d By Signature Date _ 01�7-'14 14;53 FBOM- T-790 P002/002 F-815 /-� �� -�g/ " � " � � City of Orono � - � � � ' P.o.Box 66 �� 2y50 K�ll�y Perkway - Cryatal Buy,MN 55323 �(952)Z49-46001 Fax(952)249-4(t6 CITY OF ORONO—S�V'VER&WATER/GENERAL PERMIT (*Note:5o�ac pecmits may require approval by the Building Ofiiciel end/orl�ublic Works Dep�4neat�) AY.L PERMIT - Me be mth er.t te A�rtArx rr.vi. be ib9aud hen fhe 8 licetion ib teceivdE � 1. You may apply for utility permiYs by mail or in person at the City offices. 2. Mailed in applications are subject to the postage and handling fee shown below. Pe�7r►it cards will bc scnt by rttum mail Within 2 business days. 3. Permitss are not valid until you XeCeilVe a�fCf ixllt Cal'd 4. Work must not begin unless the permit card is available on the job site. 5_ Utility connection permits may be assued to licensed contrxetors only. 6_ Contact the PubIic Works Deparanent(952-249-4640)for utllity stub as-buiCt locations. DO NUT EXCAVATE�N A,N`1C STRE�T ANb b0 NOT TAp AN'Y MAIN wIthout eapress approval ot the Public'Works�epartment. Tssuance of a permit does not gxant 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. �Residential(Ma�+Require ApproWal) ❑CommerciaC(Approval Required) �New Conncetion []Additional Connaction �Re-Connection ❑Repairs ❑Disconnect [] Water AvBilabiliCy Conneetion For Futurt Hook-Up to Water Site Address: �� '�� w�. 17��U� � (7 r�h p ' � Owner: ��v►.� �fr1�S Mailing Address: � �� Sf t�� rl�/� Su� � City: �c.��r�S✓� zip: -�i., .3 3 � a USr�,C� . �Ie�e phone:� q��=�� Alternate phone: � Contractor: M r n ne.x�t.� ��rt�L�N04S,�-r�ontact Person: �� Yh�,S � �c�. ��v"'`�� Address: �X7 W C, � � State License#: . ��'�� City: ��f�sv��. Zip:� ,��ExpirationDate: phone: �1 S� �9Ss��'I 1 � Alternate phone: � ,01�7-'14 15;23 F�OM- T-791 P002/002 F-816 Q SAC Char�e(2014 Itate=SZ,4$5.00) S (SAC Char�e muat accompany all sewer permit applications unleas prepsid) (Orono City Staff can determine if applicable) (If not prepaid,a sew�er connect5on permit will not be issued) r �Sewer Cannection/Disconnect/Repair(550.00/Per Stub) S aD Pipe sizc inchcs;matcrial Schd 40 sir tcsCcd; cast iron b!'�"�•.r.r ❑Wate�Connection/Disconbect/Repair(550.00/Per SCub) $ Pipe eize inches;material Schd 40 air tested; copper []'1�Vater Avai�sbi�itty k'o�r b'uture Hook-Up to Water($50.00) $ � '1'Vater Availabilitv Fsolanation: Contractor installed line ta inside of housc for futurc hook-up. This 1'1ue will be i�lspected by tbc Public Works Dcparhncnt. Rec�uired Be�91'&_ ater(:nnnection Pertnit is Issued: � 1. �esue Water Meter&Horn Penni,t • 2. Any Additional Connecfian Fees Paid(If Applicable) � Issue'Water Connec'o it: 1. Collect Permit Fee&Issue Water Conuection Permit . 1. S�TO�'AI.of Pexmit R,equestcd: $ 2. STATB S�tCHARGE $. 5,00 3. pOSTA(�B&HANDI.ING(Only on Mail-In Applications) $ ' 2.00 4. TOraY,p�1�T FEE(A.dd�.�n�s r-3 Abovc) : $ �7 � , o � WATER METERS must be picked up ar►d paid for at Orono City Hall,thcsc arc on s st�arate permit: • WA�R N�TERS mnst be aet and gealed by Orouo'1VVater Aepartment(952) Z49-4600, upon completion of�aueter installation. , , � The undersigned hereby applies to the City of Orono for issuance of a Utility Permit,agees to do all work in strict accardaz�ce with the ordinances af the City and the regulat�ons of the �tate pf Minnesqta,and eertifies that all statements rnada on this applieation are,true and cormct. Applicant• � ��+L� Date:��1� ATE TI� �/ CITY OF ORONO CALLED w ` f, � INSPECTIO�ICE SCHEDULED `3V � PERMIT NO. COMPLEfED ADDRESS -� 1 �' �„'�-� OWNER TELEP O. ��2'Z�' 3�' `3� CONTRACTOR �� Or�� i � DESCRIPTION �`��'� �� k— � . - ` � � ❑ FOOTING ❑ PLUMBING FINA� ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ W - P ❑ PROGRESS � ❑ FINAL SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ fOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL 2 OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: ��=�v�CG- ,eS�G�l��.c�' ��f t��,r' f�N /f/� � l�c.:�jv�-� of' 1�iis.S� �yR �i�.�i�Y �<'�75��r/ Tc��iz%�' � J, ��N��fir.'S_ �it�'f� �:.1'�- �. � O � Q �l70�� , �J' � 2 W � W � j d W� ❑WORKSATISFACTORY:PROCEED ❑ PROJECT COMPLEfE W ❑CORRECT WORK 8�PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN INSPECTOR W4LLREfURN ❑CITATION ISSUED ❑STOP ORDEFi POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 2a hours in advance. (g52) 249-46�� OwnerlContractor o site: Inspector. White Copyllnspector's File Canary CopylSite Notice