HomeMy WebLinkAbout2010-00919 - sewer & water • ?' CITY OF ORONO PERMIT NO.: 2010-00919
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUED: 09/30/2010
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 100 ORONO ORCHARD RD S
PIN : 02-117-23-21-0032
LEGAL DESC : ORCHARD VIEW
: LOT 001 BLOCK 001
PERMIT TYPE : SEWER&WATER
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : CONNECTION
NOTE: THIS PERMIT IS FOR NEW SEWER CONNECTION
SAC CHARGE OF$2100.00 WAS PAID BY HOMEOWNER-CHECK#4391
APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00
GROTH SEWER&WATER STATE SURCHARGE SEWER&WATER 5.00
775
775 TOWER DRIVE TOTAL 55.00
HAMEL,MN 55340-
(763)478-6712
Minnesota State License#:058606-PM
OWNER
HUTHWAITE,MICHEAL&MARILYN
100 ORONO ORCHARD RD S
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 an i e for due cause. a
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.. icant Permi -e Signat re Date Issu:':y Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
• SENLY
— '4 City of Orono
gDate lteeei a y ennit# •" � �l
/ 'C) P.O.Box 66
r,e 2750 Kelley Parkway Q In HouseSAC Detetmpnation Form Completed,
Crystal Bay,MN 55323
';- 6 (952)249-4600 Alrproved 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 application is received)
GENERAL INFORMAT ON
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.
TTYPE PET
❑Residential(May Require Approval) ❑ Commercial(Approval Required)
Tew Connection ❑Additional Connection ❑Re-Connection ❑Repairs ❑Disconnect
❑ Water Availability Connection For Future Hook-Up to Water
rob.Site 1 Owner T11ti atl{311 ;
Site Address: /0C, 0 r 0 V\ 0 c-C (-\,q 444, 5 ,
Owner: r c,`)II I
� h A t A \A Mailing (.1)4,0 no Address: � o doh .41v,dlo
City: - -
Zip: 3 4t I
Home Phone: 7 S 2 -(-47 --LC 2.lQ Alternate Phone:
Contractor Information:
Contractor: Ctb 5 , 4)u- , Contact Person: t `—,
Address: '1 State License#:
City: 4A \42-A- Zip:/v Expiration Date: 2/21 / (o
Phone: 1 .6 3 14'? -- 11--- Alternate Phone:
Co' z-- 2 s(3-63Y.--
4 4
DETE• `'',,0 . .A. I .. '.:
❑SAC Charge(2010 Rate=$2,100.00) $
(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)
ewer Connection/Disconnect/Repair($50.00/Per Stub)1?6
$ �' vv
Pipe size inches;material Schd 40 air tested; cast iron
❑Water Connection/Disconnect/Repair($50.00/Per Stub) $
Pipe size 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: $ NO` el)
2. STATE SURCHARGE $ 5.00
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ X2.000
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ ,5-5. U()
• 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.
Applican"a a. Date: V;07/0
19) LE
C d 20Itk TIME
CITY OF ORONO CALLED IN
INSPECTION OTIC SCHEDULED I-7--yD '�
PERMIT NOYD`0-OD9/9 COMPLETED
ADDRESS /OD 9 o tc' &"C-Aa-tri /ed
OWNER TELEPHONE NO. (0/7--250 -015
CONTRACTOR Gro
• DESCRIPTION /7-v
0 FOOTING 0 PLUMBING FINAL 0 EXCAV/GRADING/FILLING
Q 0 POURED WALL 0 MECHANICAL RI 0 LAKESHORE/WETLANDS
CI) 0 FRAMING 0 MECHANICAL FINAL 0 TREE REMOVAL
0 INSULATION 0 WOOD BURNER/FIREPLACE 0 SITE INSPECTION
Q 0 RADON SLAB 0 WATER HOOK-UP 0 PROGRESS
0 FINAL 0 SEWER HOOK-UP 0 COMPLAINT
▪ 0 DEMO-SITE 0 SEPTIC MAINT. 0 FOLLOW-UP
i ❑ DEMO-FINAL 0 SEPTIC INSTALL 0 HARD COVER REMOVAL
0 PLUMBING RI 0 SEPTIC FINAL 0 FOUNDATION/REMOVAL
2 OWNERICONTRACTOR TO MEET YOU:_YES_NO
• COMMENTS:
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LuWORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W RRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
• 0 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
C.) BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
El INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
OwnedContraci/to-r o'r�s'
Inspector. r(J •/RE
White Copy/Inspector's File Canary Copy/Site Notice