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HomeMy WebLinkAbout2018-00219 - sewer/water re-connect CITY OF ORONO I MI H UI V 1, 111 Will 2750 KELLEY PARKWAY * 2 1 S - 0 0 2 1 9 DATE ISSUED: 02/28/2018 ORONO,MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 2665 CASCO POINT RD PIN : 20-117-23-23-0021 LEGAL DESC : SPRING PARK : LOT 136 BLOCK 000 PERMIT TYPE : SEWER&WATER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : RE-CONNECT NOTE: WATER&SEWER RE-CONNECTION APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 WATER CONNECT/DISCONNECT/REPAIR 50.00 GROTH SEWER&WATER STATE SURCHARGE SEWER&WATER 1.00 775 775 TOWER DRIVE TOTAL 101.00 HAMEL,MN 55340- (612)919-0247 Payment(s) CHECK 11437 101.00 OWNER GUTERMUTH,DAVID&LYNN 2665 CASCO POINT RD 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 be revoked at any time for due cause. 1116 °A4 r Pfticzo Applicant Permitee Signature Date Issue 1J y Signature Date VV✓ FOR CITY USE ONLY sL0 ` City of Orono Date Received: -s'$ Permit v �L'1v2 P.O.Box 66 2750 Kelley Parkway 0 In-House SAC Determination Form Completed ytiii, ) Crystal Bay,MN 55323 ke s�i o¢_v (952)249-4600/Fax(952)249-4616 Approved By(If Required): v- 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 aanlication is received) GENERAL INFORMATIOl 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 PER?' IT (Check All That Apply) Q Residential(May Require Approval) 0 Commercial(Approval Required) 0 New Connection ❑Additional Connection Re-Connection 0 Repairs ❑Disconnect 0 Water Availability Connection For Future Hook-Up to Water Job Site/Owner Information: Site Address: o�C (0S Cots (0 fo),f- Ri Owner: °(-r " )`1141e-1 Mailing Address: City: Zip: Home Phone: Alternate Phone: Contractor Information: Contractor: ( ro'ILL CeLier t- L'y/Cr Contact Person: 0e✓c(� /(iik(- 0 Address: 77C T L'"'r 10,-fv-e- State License#: City: l-1-,,,v1e.J Zip:-55171-0 Expiration Date: Phone: (,(/),- 1/ 40-70 Alternate Phone: DEIERMNIIsKi PERMIT FEES ❑ 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 4,1 inches;material Schd 40 air tested; cast iron ®Water Connection/Disconnect/Repair($50.00/Per Stub) $ Pipe size 1" inches;material 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 $ 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: Date: l�� /e DATE TIME CITY OF ORONO CALLED IN INSPECTION AIO3IC ��� SCHEDULED (?///`87 � PERMIT NO. COMPLETED ADDRESS . ?iP -5 &'GQ /774- /ed OWNER ( TELEPHONE NO.I`R- "/ z6� 4, Qra� � CONTRACTOR DESCRIPTION v 'V , / .1 W ❑ FOOTING 0 DEMO-FINAL 0 SEPTIC FINAL Q ❑ POURED WALL 0 PLUMBING RI 0 EXCAV/GRADING/FILLING Q ❑ FOUNDATION DRAIN TILE 0 PLUMBING FINAL El REMOVAL ❑ LATHE 0 MECHANICAL RI 0 SITE INSPECTION IT 0 FRAMING 0 MECHANICAL FINAL 0 RATED WALLS ❑ INSULATION 0 WOOD BURNER/FIREPLACE 0 COMPLAINT Q 0 FINAL 0 WATER HOOK-UP 0 FOLLOW-UP _141 ❑ AS BUILT-SURVEY 0 SEWER HOOK-UP 0 FOUNDATION/REMOVAL v ❑ DEMO-SITE 0 SEPTIC INSTALL 2 OWNERICONTRACTOR TO MEET YOU:_YES_NO Ei COMMENTS: !E`er✓ (, �/ d� g/( i"1 54i) ft, L Q. 1Pi.c>�' j-4„I��r y .. -1,-(i/2 J ..0 / !/ 7 - 0 46 IZ Xl/40/' W Z W CC Lu RK SATISFACTORY:PROCEED PROJECT COMPLETE CC W CICORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O O CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING �/ PERMANENT El CORRECT UNSAFE CONDITION WITHIN HOURS. PHOTO TAKEN INSPECTOR WILL RETURN ✓ 0 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 Owner/Contractor on site: D A i r — .. .,./.9-71c.if- Inspector. 5�'!� White Copyllnspector's File Canary Copy/Site Notice c p.' t, , 0 ''ItoosilMillik. r " . 02. , 3-/' •* 1 - • r S k 411001,. ,(11S(g.: . + =' 4, ,� -.tip 41M ji A C E." ' 4 s '•:, !4 , •,40, .,„.„, - ,_ w 9 • .,- .„... , ..,, , . c... . - - „,„ ,t). 30 N.,. .., psi * di 4 ,, pre51,,,e_ ... .... -- . .,. ,•,,,,. ,,,iiii.._ . 4 . �f�s 'r ", i _ � . y. • T 4-4.! ' '04 4 ,� #r f » iik 41,x, oiliS OS fir 11 ® per } $ , '., . ', 4 ' .04 1 tlip , � .rt : 1 lilt ,,,,,'.„...i,1..., , 00100 /,;.; .,-, .it, ,. -,,,•.. , g , . 7111tr lir 11 illr • ?kill 449,,, .,,.',%,,.,,....:..,._,. ,,... , i so, �t , •4; a 1 .6 �� Milk- 4ri*t . ., 3-//8yy u ,, ''(.. 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