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Home My WebLink About2018-00223 - sewer/water connection CITY OF ORONO .�11 1 111111 1 11 ii �I .1.1:1111 2750 KELLEY PARKWAY DATE ISSUED: 02/28/2018 ORONO,MN 55356- (952) 249-4600 FAX: (952)249-4616 ADDRESS : 2839 GOLDENROD WAY PIN : 33-118-23-24-0029 LEGAL DESC : ORONO PRESERVE : LOT 4 BLOCK 3 PERMIT TYPE : SEWER&WATER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : CONNECTION NOTE: SEWER&WATER CONNECTION • APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 WATER CONNECT/DISCONNECT/REPAIR 50.00 D.S.M.EXCAVATING STATE SURCHARGE SEWER&WATER 1.00 2916 ENTERPRISE AVE HASTINGS,MN 55033- TOTAL 101.00 (651)480-1355 Payment(s) CREDIT CARD 5166 101.00 OWNER OP5 Orono LLC 15250 WAYZATA BLVD#101 WAYZATA,MN 55391- 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 he revoked at any time for due cause. Applicant Permitee Signatur Date Issu9y Signature Date \ FOR crrY USE ONLY 7- D City of Orono Date Received:'-- P.O.Box 66 a. l if Permit!1 Z Uj -oE23 2750 Kelley Parkway 0 In-House SAC Determination Form Completed ,t-/ Crystal Bay,MN 55323 \�r'ricesaoss,c, (952)249-4600/Fax(952)249-4616 Approved By(If Required): 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 subiect to further review and may not be issuedivbea the afolication is received) GENERAL INFORMATION 1. 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 OF PERMIT (Check All That Apply) (Residential(May Require Approval) ❑ Commercial(Approval Required) SZT New Connection ❑Additional Connection ❑ Re-Connection ❑ Repairs ❑Disconnect ❑ Water Availability Connection For Future Hook-Up to Water Job Site/Owner Information: Site Address: dB? 6/c' ,t -d Zci, Owner: D/4ViO WM'`Ii Mailing Address: City: Zip: Home Phone: Alternate Phone: Contractor Information: •Contractor: L),S,A1, tkz.-�i9ti,Vb /Contact Person: /moi 461-/Are/.4 Address: Sn g/t / k3`V Xikt , State License#: City: "/A/Sy%N1.S Zip:C�33 Expiration Date: Phone: 4.Y /PP./3j Alternate Phone: G/eQ, fly. 93 /3`" DETERMINING PES FEES D 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 Connection/Disconnect/Repair($50.00/Per Stub) $ Pipe size l inches;material Schd 40 air tested; cast iron p'Water Connection/Disconnect/Repair($50.00/Per Stub) $ /" Pipe size / inches;material Schd 40 air tested; copper 0 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 $ 1.00 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: 4 // S Date: cl'1;,--- 5P-A---- // DATE TIME CITY OF ORONO CALLED IN W INSPECTION NOTIC SCHEDULED 7. is Dv PERMIT NO.�ID--06 A COMPLETED ADDRESS CMC`) EdAzrcece L. , OWNER TELEPHONE NO.4 491'2t/'43 It iO CONTRACTO�5JR- 4A P DESCRIPTION 6c4 0avc., W 0 FOOTING 0 DEMO-FINAL 0 SEPTIC FINAL Q ❑ POURED WALL 0 PLUMBING RI 0 EXCAV/GRADING/FILLING Q ❑ FOUNDATION DRAIN TILE 0 PLUMBING FINAL 0 TREE REMOVAL ❑ LATHE 0 MECHANICAL RI 0 SITE INSPECTION Q 0 FRAMING 0 MECHANICAL FINAL 0 RATED WALLS 1, ❑ INSULATION 0 WOOD BURNER/FIREPLACE 0 COMPLAINT Q ❑ FINAL 'WATER HOOK-UP ElFOLLOW-UP LAJ ❑ AS BUILT-SURVEY AErSEWER HOOK-UP 0 FOUNDATION/REMOVAL v ❑ DEMO-SITE 0 SEPTIC INSTALL Z▪ OWNER/CONTRACTOR TO MEET YOU:�YES_NO c(., COMMENTS: txLu o -/ - ,t.- /7.-cd t-- 7 c/'�'+r''e N. cc o Z/ I>B 5, W CC Q W Z W CC J LU RK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W 0 CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY O 0 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY C.1 BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. OHOTOTAKEN INSPECTOR WILL RETURN ID ❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED 0 INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 Owner/Contractor on site:_ lF Inspector:_ _4t/' White Copy/Inspector's File Canary Copy/Ste Notice W c•-• J1 n .1-I r Curb Box Install/Repair Sheet DSM Employee: Curb Box: Damaged/No Charge/New Extras&Notes: Date: List Parts Used: f Contractor: Address: Hours Worked on: City: Superintedant Notified? Yes/No