HomeMy WebLinkAbout2017-00001 - sewer connect I 1111111 I l.. II II 1111111 .111
, ,� CITY OF ORONO * 2 0 1 7 - 0 0 0 0 1
2750 KELLEY PARKWAY SSUED: 01/03/2017
ORONO,MN 55356-
(952)249-4600 FAX: (952)249-4616
ADDRESS : 570 ORONO ORCHARD RD S
PIN : 02-117-23-31-0057
LEGAL DESC : MINNETONKA BLUFFS
: LOT MB BLOCK 13
PERMIT TYPE : SEWER&WATER
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : CONNECTION
NOTE: WATER AND SEWER CONNECTION
APPLICANT SEWER CONNECT/DISCONNECT/REPAIR 50.00
KOTHRADE SEWER&WATER WATER CONNECT/DISCONNECT/REPAIR 50.00
12059 WHITETAIL AVENUE STATE SURCHARGE SEWER&WATER 1.00
HANOVER,MN 55341 MAIL-IN FEE 2.00
() TOTAL 103.00
Minnesota State License#:plbg-RP645681 Payment(s)
CREDIT CARD 9381 103.00
OWNER
J Brunello LLC
230 BROADWAY AVE N
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.
6----7/1A_Adt C) PI,I
Applicant Permitee Signature Date Issued By gnature Date
c
IP. d4
FOR CM,USE ONLY "'°
City of Orono Date Received:/-3/7 perish QW/ Q9Ovt-.
P.O.Box 66
2750 Kellry Parkway ❑In-House SAC Determination Fonn Completed .',�
stsic.4-04/c---
,J Crystal Bay,MN 55323
tcsNoa�G` (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 subject to further review and may not be issqed when the aapllcation is received)
GENERAL INFORMATION
I. 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)
7 Residential(May Require Approval) ❑Commercial(Approval Required)
❑ New Connection 0 Additional Connection tgt Re-Connection ❑ Repairs ❑ Disconnect
❑ Water Availability Connection For Future Hook-Up to Water
Job Site/Owner Information:
Site Address: 5 90 O'OnQ Ol(.t Imo.
Owner:) ' wile]\D ( ,A,(i . Mailing Address: ki
City: WOle Zip: n vt
Home Phone: Alternate Phone: (Q .2 .% 3 b2Co()
Contractor Information: -
Contractor: 466. 1l
a ) I Contact Person: ?1,111. VA-1101.0d1 ,
Address: ‘20��1J'l,i�k lti 1i1 State License#:
City: Zip 41 Expiration Date:
Phone: 116 )tO1/t07 Alternate Phone:
r .
fr`
1, �:'47DETERMINING'PERM1T G ' ' , ••,.3.i:.
❑SAC Charge(2016 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)
Seweonnec ' /Disconnect/Repair($50.00/Per Stub) $ 56, (50Pipe size inches;material Schd 40 air tested; cast iron
IlkWater nnectio Disconnect/Repair($50.00/Per Stub) $ ,`�- -b,z5z)
Pipe siz 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:
I. Issue Water Meter& Horn Permit
2. Any Additional Connection Fees Paid(If Applicable)
Issue Water Connection Permit:
I. Collect Permit Fee& Issue Water Connection Permit
1. SUBTOTAL of Permit Requested: $ /On , Q
2. STATE SURCHARGE $ 1.00
3. POSTAGE& HANDLING(Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ 103_6-6
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: it,r,,(_(ii-d- Date: I '3 "
Receipt RI Name Customer ID Description Payment Payment Payment S Transactio Payment Collection Deposit A Deposit/C Paid By Account
Method Type tatus n Date Amount Amt mount hargeback
Date
1Ik
water permit conn a Credit Billing Successful 01/05/2017 $50.00 $50.00 $50.00 Customer RT23 II I
2 9976 dj/2017-00001 10:52:09
Page Total:I Transaction
$50.00 S50.00 $50.00
Grand Total:1 Transaction
$50.00 $50.00 $50.00
C.)
' 4110
CITY OF ORONO CALLED IN „,, Nr1466
INSPECTION NQJ C�., SCHEDULED /— a
L -=
PERMIT NO. OO) !! �� COMPLETED
ADDRESS O7O Ori w O(643i ce _�d 5
OWNER TELEPH`O.,E NO. f� — }1
Q 'GtJ '/
CONTRACTOR e/v�
E DESCRIPTION :t/V-07 / / /,
W 0 FOOTING 0 DEMO-FINAL 0 SEPTIC FINAL
Q ❑ POURED WALL 0 PLUMBING RI 0 EXCAV/GRADING/FILLING
C 0 FOUNDATION WATERPROOF 0 PLUMBING FINAL 0 TREE REMOVAL
Z ❑ RADON SLAB 0 MECHANICAL RI 0 SITE INSPECTION
Q 0 FRAMING 0 MECHANICAL FINAL 0 RATED WALLS
Is ❑ INSULATION 0 WOOD BURNER/FIREPLACE 0 COMPLAINT
Q ❑ FINAL 0 WATER HOOK-UP 0 FOLLOW-UP
W 0 AS BUILT-SURVEY 0 SEWER HOOK-UP 0 FOUNDATION/REMOVAL
❑ DEMO-SITE 0 SEPTIC INSTALL
-/
Z OWNER/CONTRACTOR TOM�r YOU:_YES_NO
(Si COMMENTS:_ ”f p u-c - 05 0, Y / C-o/
W r�
4 30 U 7:i b" Jy- 7-6 15,61 � :,_,.--frc�u27
j
ons>> ti k4174 /'u�� yC'
14. ) 5 p 1-4,$3 L.),---z4, ,24.- 7 /6 l'-' ) 5-- A i,, L)4..,.
141 C
et ,41/ ° _ ,a-// - l/)/1 ) 5
i01) , i' ' 1 , 7 3l1 At - ---. .__....5.-.04 ,1/ (/1
LAJ
W
cc
IQ WORK SATISFACTORY:PROCEED 'VPROJECT COMPLETE
CC' O CORRECT WORK&PROCEED CI ISSUE CERTIFICATE OF OCCUPANCY
41
0 0 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
o CORRECT UNSAFE CONDITION WITHIN HOURS. 'V 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'n 9dvfnce. (952) 249-4600
OwnerlContractor on site: c 'Czr C/
Inspector.
White Copyllnspector's File Canary Copy/Site Notice
. - - , 74 ' •-' ;.' -.v.). '-:•i-Y -4.4-,•"' -- - '.,.. , ...NO*"
-.-,..„,, ft.;','". 5 ;...• 4.,. 4"w Or
.•
'.' ..1'r•i. ' ".. ;, t.;..- : ?.4 Or,*. "..'. , , ••-11„, . „,,,,_,,
= .-r" . • ' -
-A 6 ... -:. : AW:',41«. -• '-,4:-4: 40-- '" 6
- . . , , •
..- . , IN ,,,,
4
.••• w" ..,
w...4,00,. mks i.' •'t ".. 'i,.. "''
'1141'1.1'"'•- 4 . .. -,',,‘,. , -
'...:.'. .'":.,/,.1401°—• ..- .----solikk . • 1. . Ile ` 1..."‘
.
..... ....
. . ,
,,,k,, • ., . ,,,,,,,• ..,,, , ,,..
',...‘
"P,,,-, .. '-.1.47;P:- - • .--.--;-.,- .....r; •*
. 110
'IV .„lip*,• • ,i
•,
11 '
t...,' ' .. - ....w wi., ..,•,,,t /4,1111111111) Sa.) , ,
i I } • .
I . , I
, .......... ---
\•,... ....1
.• . . .. --
A3', ' , .•
••". . ' . ..
* W .
g'•; ; •-•.'-,:- ' ,'' • -:: .,,....":_,,',-: (1Y1 CD ,
,,,I. 4% =. 1.11 w
... ...
, • •,,„t ,.,•,'":!".,-- ,;,..k•,,.,".",-,.._ , . 1)
:. 0 -
(1) .'
' .‘,. ' 7 •-"-4* • --4,.,-* .: .;1:,•z••'-
"--S'
.."0'
. .
.17k
CI
• .
t•-•• - -
_.-,
- --„k„ -
. . ciL 0 ....s
•
\ - . _..
...„-
11111 . -,..
..„„s . . W..,-;
10 ';
.0.'•. . ' . -: :sr * ,'"''
...A. 'a ' . ....... , „.
MMUS4 ,,,, '
r
A., o
-IF-/.
.
...
- ,$7-
-' 4" ' -•.100 ,
.4 .... .....,_
i. ..
01 . „,
... • '.1 14. 1g
: , . ..-„,,,:. .. •,.... ._ - ,-_.... ,..., .,„,
,t••." ,..-A .,
....,
# w4., .. i•.4.#°.. , .. 4 40/Yi ,,,,,• ,,„..,(,f.'lijcfr.,.." '•
A
513 ,. ..
•
ry,- ., •
0 '' Wit, '-0014,. „b. :...,_, ,40. ..
. .
e•
-, 104, .
.... ..
...
.!... -
• ..iiiitiW Aft.",,4'SW: .1. .: •4'' 1 $.4.. •7.:04:' '.•
!..' ".*:1,,A•tli.
,. , "S''44, / •44. IV'...'.
*4.- . .,. •....,11• ..1...
. e7.•
40.t 4#: ;•..' ' -.. •, • .
'‘70zoieb. C•-• 4,er.v...: 4,
%,_IV i• • Z--` ,
I, '..... ' ..'...-• . 1 yil
' 114.-%.* '.,-,7. •,=-..,-:-Tor - -- -'-'. .-- ' ',.. '„,,...
..,...„ ,,, , ....„.. j„.....,...,„.,,... .. ...„,;,
... -,.....,..,,,,,...,,,..,-.:, , . !....,,,,'''/..., ..1 ::: •474.-„-::„.‘„ .,-..*....
• ... . . •
.4.-
\t.
: ,,- ••-- ,--,,---, r • -..-w .
, - 4........ :, -.$,,,,.-,
•• 7-:::''''.:.. .....-,.. Ai ' ':aPt -
• .00.' 4- ,
, . ' VIS.j '' ' . -,•.....
4. - 4-:,.. --..., ..,,,,.. • 4 '',
• '- ., ,:,-,...dwg.:,. ei. .... ' • '"... _A-4r Nit
4",„ ,'" ,-(' '' 's V** - 'elle/ -.; • --7.., 1 ..i,
„4 1
, .
. ....... , ..., ...". . . ... .. . , ..,,
- • , ,
% 4.-..... n-..!0,!',..-, • ... ' ''',-.' . .
-401.11.1 ."'.
..41,. , OtlIt4t' . • , ,' .. ,
...
1.- -
.'' .1.- r4k ''' 0. '-.7:-_,,,` ::-,":7-tx..- - - -.'' . 4.—•
,...,t
: ........
4
,111.:
0.".
1111 ..:O.
..., jh $. l'i
10 4
4,' 41k..Z.. . 'T ',..,-,,, ' :4,--.. *:- -.4.... -
,,,,,Ipid 8,
.. . ,
:..„. c•-•1
., ot „ ,, 's. __ .-, 0-1, . • 1. , 4.•''''.' - ' -• .
' t: • - '.. --,i.i-- -.* ,.; ' -‘4.Flow • *"-°
- - or45 - ._ , ..„..• ,
., . , -,..- ,,•.'" •-•,,• - - -.,.,- • Aro
.
.;
..i. .--•= '. * 4 • ------ 4fijii -•- ,.,, '4 , - "ilit4 4" '...:-l'i I..: ••*` ''' *'''. d'r'' .
.• ,.
""01.^4.:4:' -" ,. . i•it...,'. 0".4'..;;, ..14' ,..,..1 ,': ...'_,
. , . .
44 '
(
leil, .;:s...• ,1111$016`, ..:4,/A.V. -. ,., ' - ,
:a. , --"Illt• • ..
,s.
. .
IS ,
4110"4- 4.' . , , . •(*!, 1., ,,,. :, ,, -.1",„„Alf,4.„, • . . •
,,...ilk ,r,:-..' ' ...,..-=',-4 ''';:v 1.` ..01..:".40) -7:1'11•5' '-.4:•;1A ' ', .
o.....
. ...
..., .'.4:-.$1,.i4. . •' ,,1 7,,.., . , .,
.„. .;/- , .. , .. ..• ...
--t•- ti7,-i '00,1 • . • ..20 -. - ./ -i2 -M.
../....., 1.4 9
1: ...
• - Ar .. . . --..
•P AA'0 ,
A :, .•,-.' , -,,,z - ',- • ,,,i."" 4 . ..`
. ',.°. ; ..;•$ ;
'"'• . tit, rt..t.t, i,77;;.--,2
.. .:
• --.. .,-.— - --PN-. . li -r,, , . , . w
-„ ,
-;-'
:„io,„,, . •• .!if. ,. •. ' •r 44.. .,'' •:,"-:t.,, ..., • ' -40., , .,
e. .
i s. �t iii,
i :1,t {�; t
.
•
!, Vit. " L 1 ' i,t ,G
,.. , . 4 . rr *, -,,,- , L l' . ',1 4% eft '',.:
t 3 f '
il
' t !
^� i
.1 1 t2,q i
1 s �} ) -I
;. .;,.. .., i,,i ' ' '.1 .. ,... :-ia(1,', I'.- i , 11:...' ':' ' ; 1 .''''' .
- A .f 1 1
:- :. 1 :: •,
',
• �, ' # i �
J ;,a t x $" > Iii lis'
- .b,. '4.,v? A ✓ i t A` a • .� ' 4 ..
• 1 { Ali
it
-'
r O ! }Ft 4 1•I ` �. fit `.
�y y
it% •
�4 ' 't""'� I. 641 1C
\I - ti,i., , , A
t.it...•4t ‘... qt.
\i _ v.; -
/ ;;r4 I .1 t'k '. Y
-� (n '41-.1 ,• . y �'
.4 A . 11, . ti'-, ,`( 1
y
�,: CD ^ y
0 0 '--1- t �1- � ' *ilk
:'r -• O Ep
' -' "rt N \ .4ti'
, :—.---.\ !,:l...11,:a:t,,:,...,.,. „::(..: ,;_:\., ..'',4': 7.;\ .'',. , '''''s
f, y
t t • 1
l ., �T CD 1
— '' .
' to \V 1
11, .0,... ....: :i wi.,-.1....,.. .f. ', . . -':'1, ' , - -/. '.` - ' •010100"°°.
1,4.4-0,...v.:, ., i., , . r ‘4,,,r,...--0 , :, . . ,... . ;!, . , t
''� �` f t •mak, • . •
• '1 ',
,411,..;4. .„1„..,k,...,....,-.c
3C"i��, {, ,,,y„.,' y� it
•: •'. I1/4
- ._ r
se
6\ ' ''' ' .',•.*$•;:‘1*2.4..'',%,,i--4;- '"‘' ' '''•'AP. —
)itii
•
1 4
y
VI/ii 49,`,. :'4,.1f•`4:;‘*" :-•,-";'•,,4',Lf•',,.'4.• .;'..r;,,,.4':*•_ei!*•7'.4•01:-4.:: r ,.... ..7
.. , r...., f•.c„/- /l's;may'. .fir yr.
i.. .. „,... . .....,_ ....,,
,,.., ..44.0._,„7.,.;?„.... _ .:. .11: ,..,;.....e...,.si..._
..,
, .00. ,. ..... ..i.)....,.......'-'411-„..fr-r•.' 41If -•
y
"
4.
r w � .t *r �. /fix 4'•„,„,„„,-;:i44,-;,,,•;,,,0
x
•
Ilk
i
o l a, ,
4 rV7'
'4'k' 1;3. ' ':..' 41 . l'i o
1:1 at ., .
..,.
.j. t` `' 9. moi/ ` } :' a -�
f
A 4 i 0
4
lik41 0.,* 4 \ t
C') •
,'• , 1 '
3• f I
t sir Ali
e `Y , `' v.
J . y p t