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Home My WebLink About2016-00326 - sewer connection .� CITY OF ORONO * Z 0 1 6 - 0 0 3 2 6 * „ 2750 KELLEY PARKWAY DATE ISSUED: 04/04/2016 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 559 PARK LA PIN : 06-117-23-41-0044 LEGAL DESC : MINNETONKA SUMMIT PARK : LOT 000 BLOCK 006 PERMIT TYPE : SEWER&WATER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : CONNECTION NOTE: SAC PAID 4228- 10/21/1975 APPLICANT SEWERCONNECT/DISCONNECT/REPAIR 50.00 STATE SURCHARGE SEWER&WATER 1.00 WESTONKA SEWER&WATER 6501 CO.RD 15 TOTAL 51.00 MOiJND,MN 55364 Payment(s) (952)472-4959 CREDIT CARD 8752 51.00 Minnesota State License#: BUIL-1804 OWNER O'DONNELL,'I'IMOTHY&JOAN 559 PARK LA LONG LAKE,MN 55356- 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 gran[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 l80 days of the date of issuance,or if construction is suspended for a period of 180 days at any time afrer work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the tate Building Code.This permit may be /� revoked at any time for due au . ' � � I �✓ � �C�,�"��J '--'v / / App icant Permitee Signature Date Issued By Signature Date ! � • %'O"'� FU]R�T�"S�ONLY �(./ � �1O� City Of OrOno Date Received: Pemrit# � J? � `� P.O.Box 66 n l ! 2750 Kelley Parkway ❑In-House SAC Determination Form Completed ��(U� / � '\, ,�-f' Crystal Bay,MN 55323 �� / i\\A�S'��¢�� (952)249-4600/Fax(952)249-4616 Approved By(IfRequired): � �� n7 CITY OF ORONO—SEWER& WATER/GENERAL PERNIIT � � �`�\ (*Note:Some permits may require approval by the Building Official and/or Public Works Departrnent*) � (ALL PERMTI'S- Mav be subiect to furth�r review and mav not be issued w6en the anulication is receivedl GENERAL INFORIvIATION 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. Pernut 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 cazd is available on the job site. 5. Urility connection permits may be issued to licensed contractors only. 6. Contact the Public Works Department(952-249-460D)for utility stub as-built locations. DO NOT EXCAVATE IN ANY STREET AND DO NOT TAP ANY MAIN without express approval of the Pubtic 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 A iy Q Residential(May Require Approval) ❑ Commercial(Approval Required) t �rNew Connection ❑Additional Connection ❑Re-Connection ❑Repairs ❑Disconnect ❑ Water Availability Connection For Future Hook-Up to Water Job Si#e/Owner In�ormation: Site Address: _ __�� c; �K �4� � Owner: Mailing Address: City: Zip: Home Phone: Alternate Phone: Contractor Information: // � / /,� Contractor: w�5��`�S �� Contact Person: F��4 � (G �"' Address: 1%�� C� ,�� State License#: City: �� Zip:�1 Expiration Date: Phone: GI��{7�'��1��, AlternatePhone: ��- 7�1-`T7� r .� . D�TFR1Vd�TTl'�C}�ER�iTI'FEES ❑ SAC Charge(2015 Rate=52,485.00) $ (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) �ewer Connection/Disconnect/Re air($50.00/Per Stuti) $ 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 Availabilitv Eaalanation: Contractor installed line to inside of house for future hook-up. This line will be inspected by ihe Pubiic 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 senarat,e�ermit. ■ WATER METERS must be set and sealed by Orono Water Department (952) 249-4600, upon completion of ineter 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 ordinances of the City and the regulations of the State of . Minnesota,and certifies that al teme ts de on this application are,true and correct. A li Date: M ��! � PP DATE TIME� CITIf OF ORONO caLLED IN �/-�' �� INSPECTION OTIC SCHEDULED �-�—/Co PERMIT NO.�� MPLETED _ ADDRESS �s� ��L'� GZ.1�j-� �NNER T LEPHONE NO. CONTRACTOR �i _� � DESCRIPTION 4~j ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING �Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP _ ❑ AS BUILT-SURVEY ��f'SEWER HOOK-UP ❑ FOUNDATION/REMOVAL J ❑ DEMO-SITE ❑ SEPTIC INSTALL ? 01MNERICONTRACTOR TO MEEf YiOU:_YES_NO � COMMENTS: l4 i+" '�'`5'� P�`55 Lv�l�s �ev 1 � j 0 � 0 W � Q � W W � � J d � ❑WOfiKSATiSFACTOHY:PROCEED ❑PROJECT COMPLETE W ❑OORRECT WORK d�PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECONERING PERMANENT ❑CORRECT UNSAFE CANDITION WRHIN HOURS. p pH0T0 TAKEN INSPECTOR YVILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cafl for N�e next inspection 24 hours in advanoe. (952 j 249-4600 OvvnerlCor�tractor on site: Inspe�tor: U� White CopyllnspecMr's Rk Canary CopyfSite Noti�