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Home My WebLink About2005-P08491 - sewer connection CITY OF ORONO PERMIT 2750 Kelley Parkway - PO Box 66 Permit Number: Pos49i Crystal Bay, Minnesota 55323 Pe►'mit Type: Sewer and water Permit (952)�249-4600 Date Issued: 3��2oos . SITE ADDRESS: 3970 North Shore Dr Mound,MN 55364 PID: 08-117-23-33-0068 DESCRI PTION: Proposed Use: Residential Pernut Class: General Permit Type: Sewer and Water Permit Perniit Sub-type(s): Sewer Connection DETAILS: Approved per resolution#: Separate pemuts required: NOTICES/REMARKS: SAC Paid#5383 - 10/26/78 FEE SUMMARY: Permit Fee: � 35.00 Valuation: $ 0.00 State Surcharge Fee: $ 0.50 TOTAL FEE: $ 35.50 APPLICANT: Hagberg Exc. OWNER: Timothy Zwart 18545 Roanoke St.NW 3970 North Share Dr Anoka,MN 55303 Mound MN 55364 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. . `/� ci'�- � ( C�!J c-L.l�7 �� APPLICANT P RMI �E SIGNATURE ISSUED BY SIGNATURE Conies: 1-File(SiQnitures Required), 1-Applicant, i-Monthlv Reports, 1-Assessin�, 1-Finance Page 1 I � �, . � � FOR CITY USE ONLY � ,�� Clty Of OCOnO Date Received: ' Permit# P.O.Box 66 . �" � 2750 Kelley Parkway ❑In-House SAC Determination Form Completed �. � �y?�� Crystal Bay,MN 55323 ��.'�'��O�a� (952)249-4600 Approved By(If Required): �ggg0� . � � . � . CITY OF ORONO—SEWER& WATER/ GENERAL PERMIT (*Note:Some permits may require approval by the Building Official and/or Public Works Department*) (ALL PERMITS- Vlav be subiect to further review and mav not be issued when the aonlication is received) GENERAL INFORMATION 1. You may apply for utility pemuts by mail or in person at the City offices. 2. Mailed in applications are subject to the postage and handling fee shown below. Pernut 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 pernut card is available on the job site. 5. Utility connection permits may be issued to licensed contractors only. 6. Contact the Fublic 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 pennit 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. TYPE OF PERMIT (Check All That Apply) ❑Residential(May Require Approval) ❑ Commercial(Approval Required) ❑ New Connection ❑Additional Connection �Re-Connection ❑Repairs ❑ Disconnect Job Site/ Owner Information: Site Address: � S 7 d y'�r�' Sh`'� l,��- Owner: �% -h. Z��Y1` Mailing Address: ��I �O /�/'t'�"� �� Qr City: Oron � Zip: S��'C � Home Phone: Alternate Phone: Contractor Information: Contractor: � lr r � Contact Person: F�k� �G��t�C Address: /�iS�/� �d�^r�.L-.c. , St�.t�Lic�nse#: jU SZ � ,,_ City: (�'vtd�-ti- Zip:5��3 Expiration Date: Phone: ��- ��4��/� Alternate Phone: �fZ ZBZ- 3ZlJ(i Jascj� Ul�jVaD�i. � � I , i � � � � . ; , . ,- , ` DETERINIINING PERMIT FEE� 1 , ❑ SAC Charge(2005 Rate=$1,450.00) $ . (SAC Charge must accompany all sewer pernut applications unless prepaid) (Orono City Staff can deternune if applicable) (If not prepaid,a sewer connection permit will not be issued) �Sewer Connection/Disconnect/Repair($35.00/Per Stub) $ `� � ' b� Pi e size inches;material Schd 40 air tested; cast iron P ❑Water Connection/Disconnect/Repair($35.00/Per Stub) $ Pipe size inches;material Schd 40 air tested; cast u•on 1. SUBTOTAL of Permit Requested: $ 2. STATE SURCHARGE $ .50 3. POSTAGE&HANDLING(Only on Mail-In Applicarions) $ 1.50 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ ADDITIONAL INFORMATION—WATER METERS ■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a separate pernut. ■ 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 the regulations of the State of Minnesota, and certifies that all statements made on this application are,true and correct. � . Applicant: r Date: 3' � �v� ;. , I ` I I . i � ! � ; � i � � , SEWER& WATER PERMIT IN HOUSE FORM- TO HELP DETERMINE SAC UNITS FOR CITY USE ONLY (*Please Key This Information On Comment Line Of Permit*) Date Completed: `� 7��`' #Of SAC Units � Completed By: � �% � *SAC Previously Paid- ��,-5 Permit# I� <c:• 7�Date of Permit *Charge 1 SAC Unit Per Home *If Multiple Homes Or Units-May Need To Pay Additional SAC Charges ❑ *SAC Grandfathered In— Permit# Date of Permit *Must have had Hook Up&Home Prior To 7anuary 1, 1973 *Refer to Helpful Hint Sheets,Or Ask If Necessary *If Multiple Units-May Need To Pay Additional SAC Charges ❑ *Commercial— Permit#Accounted For Date of Permit ' ❑ *Letter From Met Council—Showing Use-Or Additiona]Units Needed- *Contact Jodi at(651)602-1113 To Obtain Letter(Usually Building Ofticial Obtains) *Copies Ta Lyle,Street File&One On Copy Of Permit For Reporting *If unable to determine;will have to wait to be'issued until determination can be made ❑ SEPTIC Area- ***WATCH FOR THESE CONNECTIONS *** *Person Will Have To Pay Connection Fees&Assessments+SAC Charges *Refer To Current Year Fee Schedule! Don't Release Until Fees Are PAID! (Ask for Greg or Mike's Help With These) *Will Need Approval From Public Works(Greg Gappa) ❑ Special Grinder Pump Needed *Have Them Talk To Greg Gappa For Questions&Pricing *Give Them Special Hand Outs! (In Drawer With Sewer Permit) ❑ Permit Needs Approval From Public Works Approved By: �� k-'� DATE „_.. TIME v CITY OF ORONO CALLED IN -1� �• � INSPECTION NOTICE SCHEDULED ' PERMIT NO.OG��f�` I COMPLETED ADDRESS /�°� �� -Q-- �� OWNER CONTR. `�-' TELEPHONE NO. r�� Z �� U �' � f � DESCRIPTION `�'�� L�Y1 � � 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q 02 FR,4MING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL � 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Z Q OS FINAL 14 SEWER HOOK-UP O6 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP = 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL � 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL Z OWNER/CONTRACTOR TO MEET YOU: YES_NO � COMMENTS: Q� � W � /• � �--� � A '� � J O � � � O a W � Q � Z W � W � � d W� - WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE W ❑ CORRECT WORK&PROCEED ^_ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR G INSPECTION REQUIRED.CALlTO ARRANGE ACCESS. Call for the xt inspection 24 hours in advance. (952) 249-46�� OwnerlContracior r�i site: Inspector. �� - � White Copy/lnspector's File Canary CopylSite Notice