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Home My WebLink About2018-00481 - sewer/water connection CITY OF ORONO Li [ ,1 1 1 1 I I' H, * 2750 KELLEY PARKWAY * 20 1 8 - 00 1 DATE ISSUED: 04/11 9/22 018 ORONO,MN 55356- (952)249-4600 FAX: (952)249-4616 ADDRESS : 2837 GOLDENROD WAY PIN : 33-118-23-24-0028 LEGAL DESC : ORONO PRESERVE : LOT 3 BLOCK 3 PERMIT TYPE : SEWER&WATER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : CONNECTION NOTE: SEWER AND WATER CONNECTION SEWER CONNECTION 4"PIPE SIZE WATER CONNECTION 1"PIPE SIZE 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 be revoked at any time for due cause. 1:42 9,, Pi &) v,,9,/, Applicafnt Permitee Signa Date Issu y Signature Date POR CITY USE ONLY ic-01-1\t,-, ; P.O.Box Orono Date Received: Perfl»t sl 1 2750 Kelley Parkway 0 In-House SAC DadTnmation Form Completed a ;'I Crystal Bay,MN 55323 l�AE3 H 04'� (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 subleet to farther m and mai not be asaed GENERAL INFORMATION , . : J 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 (Cheek All That Apply)_ . 0 Residential(May Require Approval) ❑Commercial(Approval Required) New Connection ❑Additional Connection ❑Re-Connection ❑Repairs ❑Disconnect 71. 0 Water Availability Connection For Future Hook-Up to Water Job Site/Owner Inflation: yOgili Site Address: /8'37 4e/54/ted tiftX Owner: Mfrio Medd" /4*ire/ Mailing Address: City: 4v0 Zip: Home Phone: Alternate Phone: Contractor Information: Contractor: LLc* a.6411PCilt. keContact Person: 4/ier to ,r i v J Address: 294 6i 7',e/ot ,4 . State License#: City: 71L`1J1%44.S Zip:ssa33 Expiration Date: Phone: toS-' V8a. /3 Alternate Phone: ‘,/P y/ 9. 4/.3ya- DETERNinNwonamar FEEs 0 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) Sewem?Connect Disconnect/Repair($50.00/Per Stub) $ Pipe size inches;material 0914 Schd 40 air tested; cast iron [g(Wate Connectio /Disconnect/Repair($50.00/Per Stub) $ Pipe size 1 inches;material Ostiu 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: lie Date: y�Q Ig - 3eA+'-',:__________________/ V-.- DATE TIME CITY OF ORONO CALLED IN INSPECT! T43EX ,+.t 1 SCHEDULED / 3?a / PERMIT UUuu COMP ED ADDRESS a.. A 06(0/i io W// OWNER TELEPHONE NO.@/9 APi9 yir CONTRACTOR c---D---CM-- ,{,{�-- DESCRIPTION (AD a 1 6. W 0 FOOTING 0 DEMO-FINAL 0 SEPTIC FINAL 11. ❑ POURED WALL 0 PLUMBING RI 0 EXCAV/GRADING/FILLING Q ❑ FOUNDATION DRAIN TILE 0 PLUMBING FINAL 0 TREE REMOVAL ❑ LATHE 0 MECHANICAL RI ❑ SITE INSPECTION C 0 FRAMING 0 MECHANICAL FINAL 0 RATED WALLS ❑ INSULATION ❑ WOOD BURNER/FIREPLACE 0 COMPLAINT Q ❑ FINAL ElWATER HOOK-UP 0 FOLLOW-UP W 0 AS BUILT-SURVEY ❑ SEWER HOOK-UP 0 FOUNDATION/REMOVAL v ❑ DEMO-SITE 0 SEPTIC INSTALL 2 OWNER/CONTRACTOR TO MEET YOU:_YES_NO COMMENTS: 6/i/der / if /5-�.--:' rt -l`- cc IQ /9//off j it(/ YS�L-/� ye r oC_ e� �.b^U7L'?, cc (iuti 714 Ql 1 i ��cic; ''i 2 (AY-/4/- ?�r7%/,CC wr a -r" c--,67 0.' ,1 W z W cc al,WORK SATISFACTORY:PROCEED )(PROJECT COMPLETE W 0 CORRECT WORK&PROCEED 0 ISSUE CERTIFICATE OF OCCUPANCY 0 0 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. PHOTO TAKEN INSPECTOR WILL RETURN O 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 OwnerlContractor on site: D Inspector. White Copyllnspector's File Canary Copy/Site Notice 1 a r NICK to Ly 92 SW 11th Ave-POBox97 Forest Lake,MN 55025 651-464-3920 fax 651-464-3911 www.winnicksupply.com