Permits - Permit# 26-02 Sewer/Water - 2463 Black Lake Road - 4/15/2026 Sewer & Water Permit Application Appl"p' 0—Zg SW
4349 Warren Avenue,* Spring Park,MN 55384
SPRING PARK
on LJ4rslfinnf10?1Ca •952-999-7493,jkhoffman@ci.spring-park.mn.us
REV 1/3 012 0 2 0
SITE ADDRESS OR SUBDIVISION.LOT AND BLOCK SUITE DATE
2463 Black Lake Road LOT BLOCK
PROPERTY OWNER Gregg&Carol Steiger
APPLICANT INFORMATION
COMPANY NAME
Applicant is: Property OwnerwContractor Tenant Ouverson Sewer&Water
APPr STATE LICENSE H
1viarlmbunZ gY-751-6888 %I %VtReNrnational PkNy PB807110
EMAIL A RESS CITY New Ho ST ZIP 55428
ottice@linemysewer.com Pe "1�IN
USE TYPE CONSTRUCTION CATEGORY
Commercial 1:1MUiti-Family gesidential Church 11Commercial Industrial Other Public
New Building OR Existing Building Multi-FamtVSingle Fam Det. Townhouse Two-Fam
Detailed Description of Work:
ig in drivewa ,55'-65',replace 1Oft with Sch40 PVC.Also
Principal Building 11 Accessory Building11 Other nstall 30ft of 4"&6"CIPP. ProjN:tValuaUon S
15,250
DESCRIPTION OF WORK
Sewer&Water Connect / Disconnect I Ut
ewer&Water Repair
Sewer&Water Connect 11 Sewer Connect Sewer Disconnect
Sewer&Water Disconnect Water Connect Water Disconnect
PERMIT FEE SCHEDULE
Residential Commercial/Industrial
Sewer Connection or Disconnection S50.00 Sewer/Water Connection/ $50.00 per connection+
$1.00 State Surcharge Fe Disconnection State Surcharge Fee
Water Connection or Disconnection $50.00
$1.00 State Surcharge Fee Sewer or Water Replacement Actual Cost, 10%
Sewer and Water Connection or Disconnection $100.00
$1.00 State Surcharge Fee
Sewer&Water Replacement Actual Cost+10%
Applicant:Please read and sign below
I hereby certify that I have read and examined this document and know the same to be true and correct.I understand and agree that the work for which the permit is issued
shall be performed according to the applicable city approvals,ordinances and codes.I further certify that I am the owner or the owners authorized agent and that the
proposed work is authorized by the owner.I understand that the work shall not begin un61 permit is issued,that I am responsible for calling for all required inspections,that
work shall be accessible for the inspection.This permit shall become invalid unless the work authorized is commenced within 180 days after its issuance,or if the work
authorized by such permit is suspended or abandoned for a period of 180 days. 'Separate street excavation permits must be obtained for street cuts'
APPLICANT'S SIGNATURE DATE
116&61� 4/6/2026
--vrrwcUSE -------------
DATE AUTHORIZED TO ISSU& MARKS'
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OTHER FIEES
Plan Review Underground Utility EIMCES SAC Sewer Rec Water Rec Water Area Water Lateral
(Comm./Ind.Only)
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Jamie Hoffman
From: Heather Smieja <hsmieja@oronomn.gov>
Sent: Tuesday, April 7, 2026 9:09 AM
To: Jamie Hoffman; Jimmy Nelson
Subject: RE: Permit App - 2463 Black Lake Rd
Hello Jaime,
This permit is approved. Please make sure they call Public Works (952-249-4686)to schedule a final inspection when the
work is complete.
Permit Requirements:
Pick up debris in work and staging areas
Work and Drill Area to be restored
Soft Surface restoration restore in kind
Protect Asphalt/ Restore in kind Min. 2' x 2' Patch
Concrete Restoration Restore in kind Min. full panel, Gutter to next seam no half panels
Pot hole cores in Blacktop and Concrete same as above
Irrigation Systems restore in kind
Watermain/Services in work area
Sanitary Sewer main/Services in work area
Storm Sewer in work area
Locates to be available more than 3 days NOT INCLUDING WEEKENDS
Thanks,
HEATHER SMIEJA
:,.,-grin, trrrt. A—,iat r,,t
for Public Works. Porky & Faciblios
1 City of Orono
952-249-4686
f/th rS r� 565 Old Crystal Boy Rd I Orono, MN
www.oronomn.gov
From:Jamie Hoffman<jkhoffman@ci.spring-park.mn.us>
Sent: Monday, April 6, 2026 11:57 AM
To:Jimmy Nelson <jnelson@oronomn.gov>; Heather Smieja <hsmieja@oronomn.gov>
Subject: FW: Permit App-2463 Black Lake Rd
Can you guys take a look at this permit and let me know if it looks OK to you?
1
.-►� Jamie Hoffman
-- City Clerk
City of Spring Park
SPRING PARK 4349 Warren Ave
On Spring Park, MN 55384
952.999.7491 (Direct)
952.471.9051 (City Hall)
ikhoffman@ci.spring-park.mn.us
www.ci.spring-park.mn.us
City Hall Hours are Monday—Thursday, 7:30am—5:00pm, Friday 7:30am - 11:30am
From: Katelyn Holewinski <Katelyn.Holewinski@linemysewer.com>
Sent: Monday,April 6, 2026 11:55 AM
To:Jamie Hoffman <ikhoffman@ci.spring-park.mn.us>
Subject: Permit App-2463 Black Lake Rd
Hello!
Please see attached sewer repair permit &job map for the address listed above. We have the repair
scheduled for Monday, April 13th. Please confirm receipt, thank you!!
keqwl",
(Cctw4m ft, l"Ji.a�
coc4vice
0.vice""coewex& WUWU
Direct: 612-231-0394
Office: 612-751-6888
FOUVERSON
SEWER 5 WATER
LIONFROM
5717 International Pkwy
New Hope, MN 55428
www.linemvsewer.com
2
Jamie Hoffman
From: payment@thepaymentgroup.com
Sent: Wednesday, April 8, 2026 11:19 AM
To: Jamie Hoffman
Cc: payment@thepaymentgroup.com
Subject: KATELYN HOLEWINSKI Permit Payment to Spring Park, MN - Permits & Licenses from
TPG
ATTENTION: if you need assistance with this payment, please FORWARD this email to
tpgclientsupport@nuvei.com and include your request. Your client manager will respond.
Dear Spring Park, MN - Permits & Licenses,
KATELYN HOLEWINSKI has made a web Payment through The Payment Group for:
Payment Information ,
Date Paid: Wednesday, 08 April 2026 11:18:43 CT
Confirmation: 1VDHME
Credit Card Number(last 4 8365
digits):
Credit Card Type: Visa
Full Address- Permit or
Business Payment
First Name Last Name Name City, State & License Amount
Zip Number
OUVERSON
KATELYN HOLEWINSKI SEWER & NEW HOPE $51.00
WATER
KATELYN HOLEWINSKI can be reached at : 612-751-6888 or office@linemysewer.com if there are
any questions regarding this payment.
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