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Home My WebLink About2009-00605 - sewer connect • , ., CITY OF ORONO PERMIT NO.: 2009-00605 2750 KELLEY PARKWAY ORONO,MN 55356- DATE ISSUED: 09/2U2009 952 249-4600 FAX: 952 249-4616 ADDRESS : 3186 NORTH SHORE DR PIN : 09-117-23-32-0010 LEGAL DESC : CRYSTAL BAY PARK : LOT 000 BLOCK 000 PERMIT TYPE : SEWER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : CONNECTION APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 OUVERSON EXCAVATING STATE SURCHARGE SEWER&WATER 0.50 P.O.BOX 702 BUFFALO,MN 55313- TOTAL 50.50 (763)479-0337 Minnesota State License#: 68968 OWNER NEDDERMEYER,GLEN 709 MINNETONKA HIGHLAND LA 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. 1'his permit is for only the work described and does not grant permission for additional or related work which requires separate permiu. 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 res onsible for assuring all required inspections are requested in c o ce with the State Building Code.This permit may be revoke time r due cause. 9 ��. � � � � i i A lic rmitee Signature Date Issued By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. � . , � - �OR�T�:�7SE 4AiL•LY a,��O City of Orono �T�ateReceiued:, P=ermit�# P.O.Box 66 2750 Keliey Parkway �„�dn=F�OUSe`�AC�Dclermtriarioa:Fbrm�s�leted'� Crystal Bay,MN 55323 ' �L` � (952)249�600 a�pproue��B�+�(if�iequireil) ' ��Q CITY OF ORONO—SEWER&WATER/GENERAL PERMIT (*Note:Some permits may require approval by the Building Offcial and/or Public Works Department*) (ALL PERMITS- Mav be subiect to furt6er review and mav not be issued when the soolication is receivedl �s�''TEI�T��.�,�T�(�R�i��1*1 , 1. You may apply for utility permits by mai]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 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. Issuance of a permit 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. ��'��' � ��ie�:�.�Z��a�t. `,�tesidential (May Require Approval) ❑Commercial(Approval Required) �New Connection ❑Additional Connection ❑Re-Connection ❑Repairs �Disconnect ��cr�Y��te F1<pa�er.�Z�or=nn��iQn:� Site Address: � � �h N � �o n � f' �/ lv��,��..� �.�;I� Owner: er►� 7-U Mailing Address: City: �3 ��-t Zip: Home Phone: Alternate Phone: �� ' ��6 � �S� � Contractor':In�orrnation: ��so� �� w, � �� Contractor: Contact Person: Address: h"' �D� `7 o Z- State License#: f'c/2 6t4�/6 8 ,r� �53� 3 City: />`` �`�'' Zip:� Expiration Date: � � �� Phone: C�Z' �� — �t'�6'� Alternate Phone: '� , . ❑SAC Charge(2009 Rate=$2,000.00) $ (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/Disconnect/Repair($50.00/Per Stub) $ Pipe size�/'' inches;material_�Schd 40 air tested; cast iron ❑Water Connection/Disconnect/Repair($50.00/Per Stub) $ Pipe size inches;material Schd 40 air tested; copper 1. SUBTOTAL of Permit Requested: $ 2. STATE SURCHARGE $ .50 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ �Di'T�(fl�T�.; Y:• `��.� '-�1�.`��.:�`��, ■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a senarate 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 all statements made on this application are,true and conect. � � �� Applicant: Date: � 7 �� DATE TIME CITY OF ORONO CALLED IN I U � INSPECTION N�O/T,,I�C,E /� SCHEDULED PERMIT NO. OYJV R Od1�S COMPLETED ADDRESS � �S�o /VW�LL �d►I�_ C/JI' � OWNER CONTR. �u�l�/�GVC L(�`''S TELEPHONE NO.��J� '-"'7�77 '' �3.3� � DESCRIPTION �,(/V�JL-- � ❑ FOOTING p MECHANICAL RI ❑ EXCAV/GRADING/FILLING Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORFJWETLANDS y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE � ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ �EMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT Q ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP ? ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL v ❑ PLUMBING FINA� ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO c��, COMMENTS: � W a � J O a � O � W � Q � Z W � W � � d � ORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE W ❑C RRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ppHOTOTAKEN INSPECTOR WILL REfURN ❑CITATION ISSUED �STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call forthe next inspection 24 hours in advance. (g52) 249-460� Owner/Contractor on s e: Inspector. White Copyllnspector's File Canary CopylSite Notice