Permits - Permit# 26-03 SE - 3950 Sunset Drive - 10/19/2026 (2) t
�- Sewer & Water Permit Application APPIm e�0'
4349 Warren Avenue.- Spring Park,MN 55384 S • /� Y�
SPRING PARK .952-999-7493.1khoflmon@cl.spring-park.mn us
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SITE AODRESS OR StISM STUN.LOT AND e H SUTE UATF ^�
?42S t� 1� LOT BLOCK
PROP OVvt7ER �
APPLICANT INFORMATION
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Applicant is Property Owner Contractor OTenanl COMPANY NAME Q� ro LLC
APPLiC�v SNAME PHONED COMPANY A E^�5 1)l� SIA7E LICE
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EMAIL ADDRESS CITY ST 7E P
J v i-X)I " �6 IYN(X1(•l�� r1 CO/TRUCTION CATEGORY[]other
TYPE
Commercial Multi-Family Resldentlai Church �Commerdal �IndusWal Other �PubMc
C
New Building OR Existing Building Multi-FamoSingle Fam Det. ❑Townhouse Two-Fam
Detailed Daearl olwerk: W _{_,y,r
cap
pal Building QAccessory Building Other Project YduaUonS
DESCRIPTION OF WORK
Sewer 6 Water Connect I Disconnect OSewer&Water Repair
Sewer 6 Water Conned Sewer Conned ❑Sewer Disconnect
Sewer 8 Water D sconnect OWater Connect DWater Disconnect
PERMIT FEE SCHEDULE
Residential Commercial/Industrial
Sewer Connection or Disconnection S50.00+SewerfWater Connectior✓ $50.00 per connection+
$1.00 State Surcharge Fee 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+
S1.00 State Surcharge Fee
Sewer h Water Replacement Actual Cost+10%
Applicant Pleas.reed and sign below
I hereby cw*that i have read and examined this doamrent and know the same to be true and correct.I understand and agree that the wort for wldch the permit is Issued
shall be pedormed according to the apprZ"city approvals,adww¢es and codes.I further carBfy that I am the owner or the ownWs aullharbxd agent asd that IN
proposed work is authorized by the owner.I understand that the work shall not begin untl permit is issuaiL uw i an responabie for calling for ail required ihspectimhs.that
work sher be accessible for Me inspection.This permit shall became imraW unless the work authorized is commenced ti thin 180 days atier is issuance.or If the wort
authoized by such pemdl is suspended or abandoned for a pedod of 1ll rate street excavation permits must be obtained for street cuts'
APPLICANT'S SIGNATU TE 'DlIS
CE U8E OtA.Y
DATE RECEIVED AVT11OR12ED TO ISSUE R
OTHER FEES
Plan Review Underground Utility []MCES SAC ;CSawer Rec JEWate,Rec []Water Area []Water Latiarai
(Comm And.Only)
Jamie Hoffman
From: payment=thepaymentgroup.com@mg.thepaymentgroup.com on behalf of
payment@thepaymentgroup.com
Sent: Friday, October 16, 2026 1:17 PM
To: Jamie Hoffman
Cc: payment@thepaymentgroup.com
Subject: DOUGLAS DZURIK Permit Payment to Spring Park, MN - Permits & Licenses from TPG
ATTENTION: if you need assistance with this payment, please FORWARD this email to
tpgclientsuppQrt@nuvei.com_and include your request. Your client manager will respond.
Dear Spring Park, MN - Permits & Licenses,
DOUGLAS DZURIK has made a web Payment through The Payment Group for:
E--- I ---
Date Paid: Friday, 16 October 202613:17:16 CT
Confirmation: IGS1XF
Credit Card Number(last 4 5600
digits):
Credit Card Type: MasterCard
DOUG DZURIK 3950 SUNSET
DOUGLAS DZURIK CONSTRUCTION, DR #26-03 SE $100.00
INC
DOUGLAS DZURIK can be reached at : 612-221-2431 or builderddc@gmail.com if there are any
questions regarding this payment.
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i
Jamie Hoffman
From: Jimmy Nelson <jnelson@oronomn.gov>
Sent: Wednesday, October 14, 2026 10:08 AM
To: Jamie Hoffman; Brent Weldon; Heather Smieja
Subject: RE: permit app
Good morning,
I talked with him yesterday and advised him on what to do,They are going to be boring a new water service from the
new garage to the house and install it above the meter and will be hooking up to the existing sewer stub outside of the
old garage.They did have water and sewer in the old garage. I told him to call Heather to set up an inspection.
Thank you,
gX.0 , Jimmy Nelson
Public Works Utilities Supervisor
365 Old Crystal Bay Road N
Orono MN 55356
(952) 249-4680
inelson@oronomn.gov
Please consider the environment and print only if
necessary.
From:Jamie Hoffman <jkhoffman@springparkmn.gov>
Sent:Tuesday, October 13, 2026 9:29 AM
To: Brent Weldon<bweldon@oronomn.gov>;Jimmy Nelson <jnelson@oronomn.gov>; Heather Smieja
<hsmieja@oronomn.gov>
Subject: FW: permit app
Importance: High
Hi there—
Can you review and let me know next steps? He did stop in the city and ask some questions about
hookup—maybe give him a ring and make sure he is doing it correctly. Assume he should call you guys
for the inspection correct?
Jamie Hoffman
City Clerk
City of Spring Park
4349 Warren Ave
Spring Park, MN 55384
952.999.7491 (Direct)
952.471.9051 (City Hall)
i
jkhoffman@springparkmn,gov
https://springparkmn.gov
City Hall Hours are Monday—Thursday, 7:30am —5:00pm, Friday 7:30am - 11:30am
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