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Home My WebLink About2010-00920 - sewer connect • CITY OF ORONO PERMIT NO.: 2010-00920 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: 09/30/2010 (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 110 ORONO ORCHARD RD S PIN : 02-117-23-21-0022 LEGAL DESC : ORONO ORCHARDS : LOT 073 BLOCK 000 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#7512 APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00 GROTH SEWER&WATER STATE SURCHARGE SEWER&WATER 5.00 775 775 TOWER DRIVE HAMEL,MN 55340- TOTAL 55.00 (763)478-6712 Minnesota State License#: 058606-PM OWNER WYFFELS,JAMES&MAUDE 110 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• e for due c e. G / / O // 8 NA AA / / !v Applican Permi a SSign ture Date Issu By SignatureDate SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. FO I ONLY <. �,�0�� City of Orono Dat Recei �ertriit# t 7 P.O.Box 66 Boto 2750 Kelley Parkwayil Din ousel Determination FormCompleted :?� Crystal Bay,MN 55323 :,i (952)249-4600Appfoved By(If Required) CITY OF ORONO—SEWER&WATER/GENERAL PERMIT (A 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) GE ERA R A`1ON 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 maybe 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. x ,T1'PEp{.�PE RT 4�(+ %k�E l "4:1,---4,-,:- ly .` - I. ❑Residential(May Require Approval) ❑Commercial(Approval Required) ®New Connection ❑Additional Connection ❑Re-Connection ❑Repairs ❑Disconnect ❑ Water Availability Connection For Future Hook-Up to Water Job Site;/Owner worm n. Site Address: ) 0 Q ,-o v\ o O r a A �i-vi\p � it-Ac cot 4 S �` Owner. 1" ' .1 '� L Mailing Address: S A v,‘-e City: 6i Atl 2 4'\---A Zip: SS 3 5 ) Home Phone: 76 3 (..--i 7 g- Alternate Phone: f 2 2_7 o cj L 3 k Contractor'Information Contractor: G se.,...0---) Contact Person: (9‘) ) Address: -2 ? C '(D.-.--,--1 O- State License#: S 6 b ( P A\ City: Zip: Expiration Date: 1243) ) /J Phone: 3 y-7 - (0 1 11-- Alternate Phone: G 1 �- - 2 S 0 _L35 s- ❑ 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) �c 4Sewer 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 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: $ moo. 2. STATE SURCHARGE $ 5.00 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ ,55, DO 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: a /� Date: /q`'/7v d�-7EA TIME CITY OF ORONO CALLED IN ) / T /i v INSPECTION NOTICE SCHEDULED I L7lip, c -? CO PERMIT NO.0 Q/i)--X61070 COMPLETED ADDRESS /// Or2,1O Ore-1291?-1 /&Y` S OWNER TELEPHONE NO. (-.°4=A "... 50-4_3t- CONTRACTOR o5O'- iCONTRACTOR --7r0-1-1-? c.- ? 15 IPO . DESCRIPTION _ ` C�� > '2/7-e y) I, W ❑ FOOLING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING U. ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS h Q LI FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL • 0 INSULATION 0 WOOD BURNER/FIREPLACE El SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS • 0 FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT v ❑ DEMO-SITE 0 SEPTIC MAINT. ❑ FOLLOW-UP ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL v0 PLUMBING RI ❑ INAL ❑ FOUNDATION/REMOVAL Z OWNER/CONTRACTOR TO MEET YOU:SEPT!YES_NO o COMMENTS: c W Q. cc O '' -7✓--^ I< S r s e p4,c cc W cc Q z 7'(1_ S A.0eM e ' T--C) P rc; u rd a Lk../b•€.S€ ( f w A S Stv 5 W� ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE ( (3,e W ❑CORRECT WORK&PROCEED ElISSUE CERTIFICATE OF OCCUPANCY CZ IICORRECT WORK,CALL FOR REINSPECTION TEMPORARY ✓ BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN O STOP ORDER POSTED.CALL INSPECTOR El CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 Owner/Contractor on site: L ( j r ) Inspector. �r- S White Copy/Inspector's File Canary Copy/Site Notice INSPECTION COMMENTS: