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HomeMy WebLinkAbout2015-00669 - s/w connection 111111111111 111111111111111111111 CITY OF ORONO * 2 0 1 5 — 0 0 6 6 9 * 2750 KELLEY PARKWAY DATE ISSUED: 05/27/2015 ORONO,MN 55356- 952 2494600 FAX: 952 249-4616 ADDRESS : 3740 NORTHERN AVE PIN : 17-117-23-34-0088 LEGAL DESC : REG.LAND SURVEY NO.0763 LOT 2 BLOCK 1 PERMIT TYPE SEWER&WATER PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE CONNECTION NOTE: SEWER AND WATER CONNECTION APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 WATER CONNECT/DISCONNECT/REPAIR 50.00 J P SCHMITZ CONSTRUCTION COMPANY LL STATE SURCHARGE SEWER&WATER 5.00 16450 117TH AVE N MAPLE GROVE,MN 55369- TOTAL 105.00 Payment(s) CHECK 2854 105.00 OWNER Atlas Homes 7082 EAST FISH LAKE RD MAPLE GROVE,MN 55311- 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 governing 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. Applicant Permitee Signaftife Date Issue y Signature Date VIA cnv USE ONLY City of Orono Datc Ihr3rved: Pit# P.O.Box 66 2750 Kelley Parkway ©b4fouse SAC DoWmbation Form Completed Crystal Bay,MN 55323 952 ( )249-4600/Fax(952)2494616 Approved By(]f l�uired): �Xa.cHn CITY OF ORONO-SEWER&WATER/GENERAL PERMIT (*Note:Some permits may require approval by the Building Official and/or Public Works Department*) (ALL PERMITS- May be subject to further review and may not be issued when the aonHcation is received) GENERAL INMRMATION I- 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. 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. TYPE Off`PEIMT Check All Tim A [ esidential(May Require Approval) E]Commercial(Approval Required) New Connection ❑Additional Connection ❑Re-Connection ❑Repairs ❑Disconnect ❑ Water Availability Connection For Future Hook-Up to Water Job Site/Owner Infor flon: _Site Address: / LIo NAem Ave- Owner:. VCOwner: ! 3 Mailing Address: City: Zip: Home Phone: Alternate Phone: Contrac�ax Im�ormaton: Contractor: 5C�Jki Z (044ia,-, Contact Person: Address: [Wo 117' Avl- uv State License #: City: I 'Q lJt Zip:J J)U q Expiration Date: Phone: 763- 6 -144 Alternate Phone: f < H, ❑SAC Charge(2015 Rate=$2,485.00) $ (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 Con`,sVon/Disconnect/Repair($50.00/Per Stub) $ Pipe size f inches;material PU(- Schd 40 air tested; cast iron Water Connection/Disconnect/Repair($50.00/Per Stub) $ Pipe size t inches;material fA S Schd 40 air tested; copper ❑Water Availability For Future Hook-Up to Water($50.00) $ Water Availability Explanation: Contractor installed line to inside of house for future hook-up. This line will be inspected by the Public Works Department. Required Before Water Connection Permit 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) $ ADDITIONAL INFORMATION WATER METERS ■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a separate permit. ■ WATER METERS must be set and sealed by Orono Water Department (952) 249-4600, upon completion of meter 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: :n5 aimL T T 6,00 0 J �0, 4. i - J72A IZ t�' PA i IkW ' > va�►_�� �` _'-_ _ y �,wwn t �'j� lf'! 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',r, w t.•-fix � � 36 DATE TIM CITY OF ORONO CALLED IN oZ INSPECTION NOTICEHEDULED PERMIT NO.,C;292F " Aa-& COMPLETED ADDRESS OWNER 04 TELEPHONE NO� g� CONTRACTOR �// W DESCRIPTIONY�- W ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING C ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION R ❑ FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP i ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL v ❑ DEMO-SITE ❑ SEPTIC INSTALL ❑ FOUNDATION/REMOVAL Z OWNERICONTRACTORR TO MEET YOU:_YES_NO COMMENTS: 0 0 W Q f2 W W QC j W RK SATISFACTORY:PROCEED �OUE ECT COMPLETE ❑CORRECT WORK 8 PROCEED CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑PHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next Inspection 24 hours in advance. (952) 249-4600 Ownerr,ontractor on site: -< le Inspector: White Copynnspector's File Canary Copy/Site Notice