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HomeMy WebLinkAbout2013-00356 - sewer/water connect CITY OF ORONO * 2 0 Ii 13 II 0! e' 31 !15' s I* 2750 KELLEY PARKWAY DATE ISSUED: 05/14/2013 ORONO, MN 55356- • (952)249-4600 FAX: (952)249-4616 ADDRESS : 2359 OLIVE AVE PIN : 17-117-23-44-0076 LEGAL DESC : WILEYS NAVARRE ADDN LAKE MTKA : LOT 018 BLOCK 000 PERMIT TYPE : SEWER&WATER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : CONNECTION APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 WESTONKA SEWER&WATER WATER CONNECT/DISCONNECT/REPAIR 50.00 6501 CO.RD 15 MOUND,MN 55364 STATE SURCHARGE SEWER&WATER 5.00 (952)472-4959 TOTAL 105.00 Minnesota State License#: 1804 PAID WITH CC# 7464 OWNER Bamboo Properties LLC 1171 NORTHLAND DR #100 MENDOTA HEIGHTS,MN 55120- 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. MI 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 or assuring all required inspections are requested in conform. the State Building Code.This permit may be revok- tiause. �, i Appl ant Permi - ignature DateIssued By Si .toreate SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBE AB • OFOR CITY USE ONLY 1,Ir City of Orono Date Received: Permit# P.O.Box 66 2750 Kelley Parkway 0 In-House SAC Determination Form Completed \y / Crystal Bay,MN 55323 � ���r ����C (952)249-4600 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 subject to further review and may not be issued when the aoalication 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) '114` New Connection ❑Additional Connection ❑Re-Connection ❑ Repairs ❑Disconnect ❑ Water Availability Connection For Future Hook-Up to Water Job Site/Owner Information: Site Address: - ?< __613/L flog Owner: Mailing Address: City: Zip: Home Phone: Alternate Phone: Contractor Information: Contractor: 1/Oe'$ Z S tJ Contact Person: ��ic`? CC/4 Address: /4. 5- State License#: City: 04a--r Zip: Expiration Date: Phone: Alternate Phone: I a 7q-9772 ❑ SAC Charge(2013 Rate=$2,435.00) $ (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 (( inches;material '( Schd 40 air tested; cast iron Water Connection/Disconnect/Repair($50.00/Per Stub) $ Pipe size 7 inches;material Schd 40 air tested; copper 141y ❑ 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 ordina es of City and the regulations of the State of Minnesota, and certifies that all statement ad• o application are,true and correct. Applicant: <....7 Ct� Date: c y (J Corb 1')19 611- 237 , ok 1\ . irr , / \ .. . a . • 3... : ,: rk • . .0N.- .- .-...... . - • ..!-. ' •,'4- • t. _ . • - .-t. . -;......,,,,,i,,, . ._ , -.,-,.• . , ' „, * • t.... -.-... 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DESCRIPTION Seweiu Watt-A-7 CebtAlgtc 0 FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q 0 POURED WALL 0 MECHANICAL RI 0 LAKESHORE/WETLANDS y ❑ FRAMING 0 MECHANICAL FINAL 0 TREE REMOVAL 0 INSULATION 0 WOOD BURNER/FIREPLACE 0 SITE INSPECTION Q 0 RADON SLAB WATER HOOK-UP ❑ PROGRESS 0 FINAL ,QI SEWER HOOK-UP 0 COMPLAINT v 0 DEMO-SITE 0 SEPTIC MAINT. 0 FOLLOW-UP _ 0 DEMO-FINAL 0 SEPTIC INSTALL 0 HARD COVER REMOVAL ❑ PLUMBING RI 0 SEPTIC FINAL 0 FOUNDATION/REMOVAL OWNERICONTRACTOR TO MEET YOU:_YES_NO // u) COMMENTS: /1/ ,a// 1,()i4ier-/ire , 4 p v c Q. Se4 ce.r- 710 S.71r'P-- A`' G10a�ec ff' Cc /-1,4) 6 '' /PQccr7'. cc W 11 k 57 . /5--i AV/ Geo cc W Sem �/C-5 L4WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY CZ ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY (.) BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 Owner/Contractor on site: 7r/,4, C��r/ • SE'S/ ,4 i S11.)t v` /- Inspector. °l6 r41/7, White Copy/Inspector's File Canary Copy/Site Notice