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Home My WebLink About2011-00437 - sewer connection . CITY OF ORONO PERMIT NO.: 2011-00437 2750 KELLEY PARKWAY ORONO, MN 55356- DATE IssUED: 06/08/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 1699 NORTH FARM RD PIN : 27-118-23-44-0007 LEGAL DESC : THE FARM AT LONG LAKE : LOT 006 BLOCK 001 PERMIT TYPE : SEWER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : CONNECTION NOTE: PIPE SIZE- 1-1/4" MATF RIAL-HDPE SCHEDULE 40 AIR TESTED OTHER INSPECTION REQURIED-AIR TEST �� I �v l `3? �i APPLICANT $EWER 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 TRUSTEE, RICHARD PERKINS 1699 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 specitications,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 governing this type of work shall be wmpied with whether or not specified hcrein.This permi[will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuancc,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is res s�'le for assuring all required inspections are request con� m ce with the State Building Code.This permit may be revQked at ti for due ca � � — � � /-/ �` / �/ U / �� ; licant er rte � nature Date Issued Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. FOR CITY USE ONLY � %�'` Clty Of�1'On0 Date Received: Pennit# �� — � � ��4 ��\ r�.o.B�X�b 750 Kelley Parkway ❑In-House SAC Determination Form Completed �� p�� 1� Crystal Bay,MN 55323 1�� L��, , �o`,' (952)249-4600 Approved Dy(If Required): .r°kaeicd?-:�� CITY OF ORONO-SEWER& WATER/ GENERAL PERMIT (*Note:Somc pe�7nits may require approval by the 13uilding Official and/or Public Works Department*) (ALL PERM['1'S- Mav be subiect to further review and mav not be issued when the anplication is recei��ed) GENERAL INFORMATION l. 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. PeiYnit 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. [ssuance of a permit does not grant this approval. 7. All worl<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 ❑ Additional Connection ❑ Re-Connection ❑ Repairs ❑ Disconnect ❑ Water Availability Connection For Future Hook-Up to Water Job Site/Owner Information: Site Address: ��7 /�l, �,4c'�� /� � Owner:��L/,,4r c� e",�'r,�� s Mailing Address: ��v��-� City: O�-c ,-� � Zip: Home Phone: Alternate Phone: Contractor Information: Contractor: �,�fi,�-{� ��,�(A�� Contact Person: � Address: �7.1-�b�_.�,�-, �,�:�L State License#: G � ��o� -- r��1 � City: ..Q,--�-� ZipS S3`'�� Expiration Date: �2-� ��- 11 Phone: �� -�� F-�?/� Z- Alternate Phone: � 1 �-- 2 S � -b�i � DETERMINING PERMIT FEES ' ❑ SAC Charge(20l l Rate=$2,230.00) $ (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) ewer Connection/ Disconnect/Repair($50.00/Per Stub) $ Pipe size ��inches;material f-i�P�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]ine to inside of house for future hool<-up. This line will be inspected by the Public Works Department. Required Before Water Connection Pennit 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) $ J�S� � ADDITIONAL INFORMATION-WATER METERS ■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a se�arate 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 ardinances of the City and tl�e regulations of the State of Minnesota, and certifies t�at all statements made on this application are, true and correct. Applicant: �� Date: � � �/ �� D T TIME � CITY OF ORONO CALLED IN � INSPECTION NOTICE�c�3�CHEDULED �3 - � PERMIT NO. ��// � COMPLETED ADDRESS ��y� `�(/�-l///L � OWNER TELEPHONE NO. " 5a" 3N CONTRACTO �� DESCRIPTION �`�� '`�"�C�{��- � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHOREM/ETLANDS 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 J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ WARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATIOWREMOVAL � OWNER/CONTRACTOH TO MEET YOU:_YES^NO ��f� c�., COMMENTS: ��2�f��-C� � W a � �U ,�5�' /�,--t- �T'c'S�- � —onJ�. 0 a � ° c...�e � I � 5 ro� ' ��5 W � Q z � � S�f-i.►� ��►.�, �S �v �tnG�. � �� .e� �� c �� sr� W k � � �WORK SATISFACTORY:PROCEED �ROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFOREC�/ERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WFLL RETl1RN 0 STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Catl for the next inspection 24 hours in advance. (952) 249-4600 OwnerlContractor on site: Inspector. � White Copy/lnspector's File Canary CopylSite Notice