Laserfiche WebLink
CITY OF ORONO � APPLICATION FOR DTILITY PERMITS <br /> Box 66 (1335 So Brown Rd) ,�� i SEW'$R WATER <br /> Crystal Bay, MN 55323 .�;��' � <br /> *************************************************************************** <br /> I: You maI y�a ply�or utility pezmits by mail or in person at the City offices. <br /> 2. Mailed in applications are subject to the postage and ham3ling fees shown below. <br /> Pernut cards will be sent by return mai 1 the same day the application is received. <br /> 3. Pexmits are nat valid until y�u reoeive a �mm;t card. <br /> 4. Work must not begin unless the permit card is available on the job site. <br /> 5. Utility connection permits ma.y be issued to licensed contractors only. <br /> 6. Contact the Public Works Depart�ae.nt (473-7357) for utility stub as-built locations. <br /> DO NOT EXCAVATE IN ANY STREE'r AND DO NOT TAP ANY MAIN without express approval of the <br /> Public Works Departrnent. Issuance of a perniit does not grant this approval. <br /> 7. All work must be done in accordance with State Code requirements. <br /> 8. All work must be inspected before it is covered. Call 473-7357. <br /> 24 haur natiae required. <br /> ***************************** *********** **** **************************** <br /> JOB SITE ADDRRSS: U � � � `uS �C� �� <br /> Occupancy Type: Residential Commercial <br /> OWNER'S NAME: �d � �Je �.�, (� Phone No. : �1�,� �c� �� <br /> Mailing Address : City: <br /> CONTRACTOR'S NAIrII;: �4 `(� � O �I� Bus. Phone: � �-2� � <br /> « <br /> Mailing Address: 2�v � ����� � City: ,CJc.�r1,f . Zip: b <br /> *************************************************************************** <br /> P$RMIT TYPE AND F.SE CALCDLATION <br /> MIJNICIPAL S R CONNECTION ( $30 . 00 p ub) $ <br /> pipe size inches ; material PV on sand fill) ; cast iron <br /> SAC Charge $650.00 ) must accompany sewer permit app�i ations unless <br /> prepaid. If not prepaid, a sewer connection permit will not be issued. <br /> MDNICIPAL WATSR CONNECTION ( $30 . 00 per stub) $ <br /> pipe size inches ; material copper; other <br /> WATER METERS must be picked up and paid for at City Ha . <br /> (5/8" meters = $125 . 00 ; 3/4" meters = $163 . 00 ; 1" meters = $218 . 00 ) <br /> Water meters must be set and sealed by Orono Water Department (473-7357) <br /> upon completion of ineter installation. <br /> REQUIRED minimum setbacks from drainfield and septic tanks = 75' <br /> REQUiFED setback from sewer line = 20 ' <br /> *************************************************************************** <br /> 1. Subtotal of above permit requested $ <br /> 2. State Surcharge .50 <br /> The State Building Code Division Surcharge of .50 per permit must be <br /> included for each well, sewer and water connection permit requested. <br /> 3 . Postage � Handling (Only mail-in applications) $ 1. 50 <br /> 4. TOTAL PERMIT FE$ (add lines 1-3 above) $ <br /> ******************************************************************* <br /> The undersigned hereby applies to the City of Orono for issuance of a Utility Permit, <br /> agrees to do all work in strict accordance with the ordinances of the City and the <br /> regulations of the State of Minnesota, and certifies that all statements made on this <br /> application are con�lete, true d correct. <br /> � � JSignature of Applicant: Date: �,,� �C � ' <br />