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Home My WebLink About2010-01197 - new sewer connection • � � CITY OF ORONO PERMIT NO.: 2010-01197 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: 12/20/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 1669 NORTH FARM RD PIN : 27-118-23-44-0008 LEGAL DESC : THE FARM AT LONG LAKE : LOT 007 BLOCK 001 PERMIT TYPE : SEWER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : CONNECTION NOTE: NEW SEWER CONNECTION SAC PAID 1 U14/79 WHEN HOUSE WAS BUILT. ASSESSMENT OF$7500.00 PAID ON 10/2U2010 APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 GROTH SEWER&WATER STATE SURCHARGE SEWER&WATER 5.00 775 TOWER DRIVE TOTAL 55.00 HAMEL,MN 55340- (763)478-6712 Minnesota State License#: 058606-PM OWNER BEENDERS&PETER MONTGOMERIE,ANTOINETTE 1669 NORTH FARM RD LONG LAKE, MN 55356- 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 separate permits. All provisions of laws and ordinances goveming this rype 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 conform �rth the State Building Code.This permit may be revoked at a t� for�dUe cause. ---------...._.,. \ ,. �. y .. � � 2� /2 /2!� / d A plicant P rmit e ' n tftre Date Iss d By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. ' - , � . � ��(�-� 6��I.�Y�; . � Ci of Orono T�at�F{ .erirri3c# ��'� �� 7 �.g,o,�o � ��; P.O.Box 66 �� E; 2750 Kelley Parkway ��IIouse�S�XG�L�e�eta�u�a�4n Fo��p�e� :- Crystal Bay,MN 55323 ' � � � � '�� o� (952)249-4600 �1ppi�ued�By�1f�ieqtiue� �,�� CITY OF ORONO—SEWER&WATER/GENERAL PERMIT (*Note:Some permits may require approval by the Building Official and/or Public Works Deparhnent*) (ALL PERMTTS- Mav be subiect to further review and mav not be issued when the aoolicstion is receivedl ,�^� ��, , e rry� r,w �''�`��'�� ' � 3§• '11,� —.... . : ',. .<<� � -� g,... , _ . . .. . t.. , . , �.� ,,, . . . '�.,� .'�. . . .� 1. You may apply for utility pernuts 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 pernuts 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 pemut 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. � ;� ,� � � � �,�` , ��E�� ,�.,.,. � ��' �°� � �.�;�'�'�.�1�'�aC�;� � � � �Residential(May Require Approval) ❑Commercial(Approval Required) �New Connection ❑Additional Connection ❑Re-Connection ❑Repairs ❑Disconnect ❑ Water Availability Connection For Fuhue Hook-Up to Water �'�b��te/��Ii�z�iat�c�n § , � °�� {, a,. Site Address: � �p� � �i�r� �i¢ V'vt� K � Owner.�rP,n (�'P,�w• .w.�� Mailing Address: City: Zip: Home Phone: Alternate Phone: �'�o�r�c�r�'sr�,1�n� � � �,� �� z = Contractor: ��,`I-{� �u�e r d�,Q��e►� Contact Person: _ Address: ��-�, I d u,P r �� State License#: S�� o� �� City: .2 L Zip:7 �3�4 Expiration Date: 2 / /O Phone: ��3 �� -� ? ►�-- Alternate Phone: �I 2 � 2 S o - �3 S � y ❑ SAC Charge(2010 Rate=$2,100.00) $ (SAC Charge must accompany all sewer permit applications unless prepaid) (Orono City Staff can deternune if applicable) (If not prepaid,a sewer connection permit will not be issued) �o ❑ Sewer Connection/Disconnect/Repair($50.00/Per Stub) $ �0 � Pipe size!!� inches;material/f/pf"E Schd 40 air tested; cast iron . � ❑Water Connection/Disconnect/Repair($50.00/Per Stub) $ Pipe size inches;material Schd 40 air tested; copper ❑Water Availability For Future Hook-Up to Water($50.00) $ Water Availabilitv Explanation: � Contractor installed line to inside of house for future hook-up. This line will be inspected by the Public Works Departrnent. Required Before Water Connection Permit is Issued: 1. Issue Water Meter&Hom Permit 2. Any Additional Connection Fees Paid(If Applicable) Issue Water Connection Permit: 1. Collect Permit Fee&Issue Water Connecrion Pemut 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) $ �J � �� ADD��C�`�T:�L`Il�TF4�S��TI�7N ��V�'�ER I1%SETE�� ■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a senarate Qermit. ■ 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. � Applicant'. Date: 'L� D � / �J `-" DAT TI M E '�,// CITY OF ORONO CALLED IN / � INSPECTION NOTICE SCHEDULED o� _�� PERMIT NO��/� - ��l j�� COMPLETED ADDRESS ��Jc �, /e� OWNER �� v T�LEPHONE NO. ! - �' S CONTRACTOR S �; DESCRIPTION �% �l ✓ �✓�� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL Q ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ 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 � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a o �� - I I C�� t .� � � !c�� r"��r.� � ` � `...�1..d�� -' /�tJ � �` �� f-j U..J � (� O � W Q �/� �� : !� '�'S _7_ � Z W � W � � d W� �RK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED ❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS. Ca11 for the next inspection 24 hours in advance. (952� 249-4600 OwnerlContractor on site: , Inspector. ��r/,/�'-"I � b S White Copyllnspector's File Canary CopylSite Notice