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Home My WebLink About2018-00210 - sewer & water connection 11111112111111111111111111111111111 CITY OF ORONO * 20 1 8 _ 0 0 2 1 0 * 2750 KELLEY PARKWAY DATE ISSUED: 02/27/2018 ORONO,MN 55356- (952)249-4600 FAX: (952) 249-4616 ADDRESS : 765 BOULDER DR PIN : 33-118-23-11-0134 LEGAL DESC : STONEBAY : LOT 1&2 BLOCK 1 PERMIT TYPE : SEWER&WATER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : CONNECTION NOTE: SEWER AND WAER CONNECTION APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 WATER CONNECT/DISCONNECT/REPAIR 50.00 BOLLIG&SONS,INC. STATE SURCHARGE SEWER&WATER 1.00 11401 COUNTY ROAD 3 HOPKINS,MN 55343- TOTAL 101.00 (952)938-4133 Payment(s) CHECK 36769 101.00 OWNER Stonebrook Development LLC 17149 LINCOLN ST NE HAM LAKE,MN 55304- 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 revokedatany time for due cause. l o (p 1/ licant Permitee Si ature Date Issued B P Sm Y gnature Date �ON�\ City of Orono Date Received:/i, i b o?O/�f_Q i oZ�D P.O.Box 66 ) 2750 Kelley Parkway 0 In-House SAC Determination Form Completed s, t Crystal Bay,MN 55323 ��'ArSHo¢``�`11L- (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 maYPot be issued when the aDolkatioon is received) GENERAL L IIVFORMATIOI 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) (Y4 New Connection 0 Additional Connection ❑Re-Connection 0 Repairs 0 Disconnect 0 Water Availability Connection For Future Hook-Up to Water Job Site/Owner Information: Site Address: 76 ,r ac.,) (c,e. ,_.. lUG a qc c3 .k.)4"--- Owner: "-'Owner: Mailing Address: City: Zip: s Home Phone: lEe - Alternate Phone: Contractor Information: Contractor: (-Xc3((t -6 ),LS Contact Person: Address: ((`I° ( Cc) C< 3 State License#: City: c'Sl,S ZipSSSo1 Expiration Date: Phone: ?S-2- 73R --x(33 Alternate Phone: ' DETERMINING PERMIT FES 1 ❑ 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) r Connection i isconnect/Repair($50.00/Per Stub) $ 'ipe size inches;material Schd 40 air tested; cast iron 74 at Connecti• : Disconnect/Repair($50.00/Per Stub) $ P1. 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 I • WATER METERS must be picked up and paid for at Orono City Hall,these are on a separatepermit. • 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- I _ Date: & - ( C DATE TIME , CITY OF ORONO CALLED IN ,J��... INSPECTION IxOTIC SCHEDULED AZZ_ZILS PERMIT NO.SCJ COMPLETED _ ADDRESS 7 le-S L))O LL #f l v OWNER �{� / TELEPHONE NO.cl5 --i3 S- 9133 CONTRACTOR / 70 `. I\e, d �' DESCRIPTION 0 arh4 ne Ll vc 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 0 TREE REMOVAL ❑ LATHE 0 MECHANICAL RI 0 SITE INSPECTION Q 0 FRAMING 0 MECHANICAL FINAL 0 RATED WALLS I., ❑ INSULATION 0 WOOD BURNER/FIREPLACE 0 COMPLAINT Q ❑ FINAL 0 WATER HOOK-UP 0 FOLLOW-UP W ❑ AS BUILT-SURVEY 0 SEWER HOOK-UP 0 FOUNDATION/REMOVAL v ❑ DEMO-SITE 0 SEPTIC INSTALL Q OWNER/CONTRACTOR TO MEET YOU:_YES_NO COMMENTS: .��1 q I/ 5c.: y.6' 9 v P cr a 5;;1-A7/ may 5 - //ca. cc /¢ % 57' B' S /b5 ,- /- r•tA/ISS ! 16:Z* X 11 b k . f ( f i / �ii �� 7hW CCQ 71/'QGer I.U./ne 12 a W Z W IX CrvoRK SATISFACTORY:PROCEED PROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ElCORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. NigzE,HOTO TAKEN 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 Owner/Contractor on site: i30 l� Inspector. 5-e--0 %/ White Copyllnspector's File Canary Copy/Site Notice