Laserfiche WebLink
CITY OF ORONO APPLICATION FOR DTILITY PERMITS <br /> Box 66 (1335 So Brown Rd) y ' SEWSR WATER <br /> Crystal Bay, MN 55323 <br /> *************************************************************************** <br /> i: You mai y pply�tor utility permits by mail or in person at the City offices. <br /> 2. Mailed in applications are subject to the postage and handling fees shown below. <br /> Permit cards wil 1 be sent by return mail the same day the application is received. <br /> 3. P�ennits are nat valid tmtil you reveive a �*�+;t card. <br /> 4. Work must not beqin unless the permit card is available on the job site. <br /> 5. Utility connection permits may be issued to licensed contractors only. <br /> 6. Contact the Public Works Departme.nt (473-7357) for utility stub as-built locations. <br /> DO NOT EXCAVATE IN ANY S'IREE,T AND DO NOT TAP ANY MAIN without express approval of the <br /> Public Works Department. Issuance of a permit 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 natioe requirea. <br /> ***********************�*************************************************** <br /> JOB SITE ADDRESS: � � ���' :•d�,-�d^�� +;<���� r�� v�=���+,;, <br /> Occupancy Type: Residential Commercial <br /> OWNER'S NAME: %�; �. �{.�,n,�,. �J/�' ,�� Phone No. : <br /> Mailing Address: i :,:,, - -�,.`, u�;,��, City: %•�: ��_ <br /> CONTRACTOR'S NAME: ���i,� / ,;'/���,� ��'c Bus. Phone: ���� ���� �� i <br /> Mailing Address: i f 3i �r�/�,., :- ;-� City: �' ,�/„��:; i;..i Zip: �°����x :� <br /> *************************************************************************** <br /> ---y PERMIT TYP$ AND F$$ CALCIILATION <br /> MIINICIPAL SEWER CONNECTION ( $30 .00 per stub) $ <br /> pipe size inches; material PVC fon sand fill ) ; cast iron <br /> SAC Charge ($700.00) must accompany all sewer permit applications unless <br /> prepaid . If not prepaid, a sewer connection permit will not be issued. <br /> MIINICIPAL WATER CONNECTION ($30. 00 per stub) $ <br /> pipe size inches; material copper; other <br /> WATER METERS must be picked up and paid for at Ci _liall..------------- <br /> (5/8" meters = $133. 00; 3/4" meters = $181. 00; 1" meters = $235. 00) �' <br /> ---- _, <br /> Water meters must be set and sealed by Orono Water Department (473-7357) <br /> upon co�pletion of ineter instal lation. <br /> REQUIRED minimum setbacks f rom drainfield and septic tanks = 75' <br /> REQUIRED setback from sewer line = 20 ' <br /> *************************************************************************** <br /> l. 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 P$RLKIT FEE (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 �lete, true and correct. <br /> � <br /> / � l; ' �' ' ,j - <br /> Signature of Applicant: �/ ��. ' !�'; �=J Date: <br /> /�\ J�b <br />