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HomeMy WebLinkAbout2008-00250 - sewer disconnect r CITY OF ORONO PERMIT NO.: 2008-00250 2750 KELLEY PARKWAY ORONO,MN 55356- DATE ISSUED: 09/23/2008 (952)249-4600 FAX: (952)249-4616 ADDRESS : 280 ORONO ORCHARD RD S PIN : 02-117-23-24-0003 LEGAL DESC : AUDITOR'S SUBD.NO.307 : LOT 000 BLOCK 000 PERMIT TYPE : SEWER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : DISCONNECTION APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 35.00 PETE'S WATER& SEWER,INC. STATE SURCHARGE SEWER&WATER 0.50 800 LOWRY AVE NE TOTAL 35.50 MINNEAPOLIS,MN 55418- (612)789-6162 OWNER MCGUIRE,WILLIAM&NADINE 280 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 whe r or not speci rein.This permit will expire and become n an void yl eolistructio uthorized is not commenced withi 80 I:y efithe date of iss'. - or if construction is suspended for eriod..' 80 days at any ti after work has commenced. The applic is re : nsiblesfor assuOrig required inspections are reque ed' co•'s' ance with : uilding Code.This permit may be rev efI'at• e for dye-"c••se. i �7� ../ _ z7/ © / i 69 C271,.cipt_aj 9,33,08 i—t•e •i = mature Date Is ue• t y Signature Date / SEPARATE PERMITS REQUIRED FOR WORK 0 HER THAN DESCRIBED ABOVE. ' 3 FOR CITY USE ONLY 0 .0AO City of Orono Date Received: Permit# P.O.Box 66 2750 Kelley Parkway 0 In House SAC Determination Form Completed u• • Crystal Bay,MN 55323 `el' (952)2494600 Approved 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) 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) in Commercial(Approval Required) ❑New Connection ❑Additional Connection 0 Re-Connection In Repairs Disconnect • Job Site/Owner Information: Site Address: a SO 0 rota o 0 r C h a rd k d . S_ Owner: bah New I 'a v/< T-st Mailing Address: -7105 (o r/o ra•fe Dr- PTX- C-3S O8anlrywrde lkm� l-oans: City: Plane,, TX Zip: ' 50 Home Phone: Alternate Phone: Contractor Information: Contractor: Pe+e's Wa fey£5eivev;J.► Contact Person: J a vi e- Address: g'0 0 Lo v y ,Mie• NE• State License#: 3?/SS 9 3 City: 1 p/S Zip:fy,,, Expiration Date: // .,/o q 5-5 41 Phone: /2 - '7 F9- (e/ Z Alternate Phone: 6.f 2 —36 3 - /2-37 DETERMINING PERMIT FEES ❑SAC Charge(2007 Rate=$1,825.00) $ (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($35.00/Per Stub) $ 3s CO Pipe size inc :., , al Schd 40 air tested; cast iron ®Water Connection/Disconnect/Repair($35.00/Per Stub) $ Pipe size inches;material Schd 40 air tested; copper 1. SUBTOTAL of Permit Requested: $ 3 Jr 6 0 2. STATE SURCHARGE $ 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ 3 7. 0 0 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 : •t es • the Ci of Oro 1: for issuance of a Utility Permit,agrees to do all work in strict . . • . . - ' ith the •r - of the City and the regulations of the State of Minnesota,and - - i . all sta - .de on this application are,true . d correct. Applicantle a/ �� . J OF -�� le Date: Reset Form SEWER&WATER PERMIT IN HOUSE FORM-TO HELP DETERMINE SAC UNITS FOR CITY USE ONLY (*Please Key This Information On Comment Line Of Permit*) Date Completed: #Of SAC Units Completed By: ❑ *SAC Previously Paid- Permit# Date of Permit *Charge 1 SAC Unit Per Home *If Multiple Homes Or Units-May Need To Pay Additional SAC Charges ❑ *SAC Grandfathered In— Permit# Date of Permit *Must have had Hook Up&Home Prior To January 1,1973 *Refer to Helpful Hint Sheets,Or Ask If Necessary *If Multiple Units-May Need To Pay Additional SAC Charges ❑ *Commercial— Permit#Accounted For Date of Permit ❑ *Letter From Met Council—Showing Use-Or Additional Units Needed- *Contact Jodi at(651)602-1113 To Obtain Letter(Usually Building Official Obtains) • *Copies To:Lyle,Street File&One On Copy Of Permit For Reporting *If unable to determine;will have to wait to be issued until determination can be made ❑ SEPTIC Area- ***WATCH FOR THESE CONNECTIONS*** *Person Will Have To Pay Connection Fees&Assessments+SAC Charges *Refer To Current Year Fee Schedule! Don't Release Until Fees Are PAID! (Ask for Scott or Lin's Help With These) *Will Need Approval From Public Works(Scott) o Special Grinder Pump Needed *Have Them Talk To Scott For Questions&Pricing *Give Them Special Hand Outs!(In Drawer With Sewer Permit) ❑ Permit Needs Approval From Public Works: Approved By: *Side note,Connection Permits—Cover Septic Tank Abandonment Also,Per Lyle CkTY OF•ORONO CALLED IN 9—DAT TIME INSPECTION NOTICE SCHEDULED 9-43-a PERMIT NO. 4r. 04070 COMPLETED ADDRESS o?ry Dcc -o 7t cAa-4.a( 4ms S. OWNER CONTR. 9 .4 j5 , TELEPHONE NO. �^ DESCRIPTION v — kO A.S .II7L4(-e_elt k. L 0 FOOTING 0 MECHANICAL RI ElEXCAV/GRADING/FILLING c 0 FRAMING 0 MECHANICAL FINAL 0 LAKESHORENVETLANDS ti 0 INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL • 0 WALL BD. ❑ WATER HOOK-UP 0 SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP 0 PROGRESS ❑ DEMO-SITE ❑ SEPTIC MAINT. 0 COMPLAINT Q ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP _ CIPLUMBING RI ❑ SEPTIC FINAL 111HARD COVER REMOVAL v ❑ PLUMBING FINAL 0 FOUNDATION/REMOVAL , OWNER/CONTRACTOR TO MEET YOU:_YES NOr 9 COMMENTS: �7#5 514e'✓1 � ( s C QeJ occ dr N rvv O -c4 ,, ,�/ fZ .7 o4 /-v d 4l/, a o �� cc nJo� ��, i-. �'j 1LJY IQ Z 'IN ice( 6 W d IQ ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY C) ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY ✓ BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. 0 PHOTO 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: Inspector. SC White Copyllnspector's File Canary Copy/Site Notice