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. - � . . . . . . . . . . . .._ .. ..._.... . . N <br /> ... .' ''".... ........... . . . . . . . <br /> "_... . .. .... �; <br /> * CITY OF ORONO APPLICATION FOR UTILITY PERMITS ���C� ? � <br /> - ' Box 66 (2750 Kelley Parkway) SEWER/WATER <br /> Crys�al Bay, MN 55323 <br /> � <br /> ,, <br /> GENERAL INFORMATION <br /> 1. You may apply for 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. Permit cards will be sent - <br /> by retum mail the same day the application is received. <br /> 3, permits are not valid until you receive a permit card. <br /> 4. Work must not begin unless the permit cazd is available on the job site. <br /> 5. Utility connection pernuts may be issued to licensed contractors only. <br /> 6. Contact the Public Works Department(473-7357)for utility stub as-built locations. DO NOT EXCAVATE _ <br /> IN ANY STREET AND DO NOT TAP ANY MAIN without express approval of the Public Works ,r <br /> 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 hour notice required. <br /> JOB SITE ADDRESS: <br /> � z-C�-G� ,��'1 <br /> Occupancy Type: � �� Residential Commercial � <br /> Owner's Name: ���� <br /> Phone Number: '�-/ 7/- � ��L' <br /> Mailing Address• _ -T�' City: C`!���c: �P: <br /> Contractor's Name: ,C �- �/ ' -�, PhoneNumber: <br /> G <br /> Mailing Address: City�ti�ll.� Tp: �` J : <br /> ���� <br /> PERMIT TYPE <br /> Municipal Sewer Connection ($35.00 per stub) � <br /> pipe size inches; material PVC (on sand fill); cast iron <br /> SAC Charge ($800.00) must accompany all sewer permit applications unless prepaid. If not <br /> prepaid, a sewer connection permit will not be issued. <br /> � c� � <br /> Municipal Water Connection ($35.00 per stub) $ �� T� <br /> pipe size / inches; material copper; other " <br /> WATER METERS must be picked up and paid for at City Ha1L <br /> (5/8 meters = $133.00; 3/4" meters = $181.00; 1" meters = $235.00) <br /> Separate Plumbing Permit issued for water meter. <br /> Water meters must be set and sealed by Orono Water Department (473-735'n upon <br /> completion of ineter installation. <br /> REQUIRED minunum setbacks from drainfield and septic tanks = 75' <br /> REQUIRED setback from sewer line = 20' <br /> PERMIT FEE CALCULATION <br /> 1. Subtotal of above permit requested � <br /> 2. State Surchar�e $ .50 <br /> The State Building Code Division Surchazge of$.50 per permit must be <br /> included for each well, sewer and water connection permit requested. <br /> 3. Posta�e & Handlin� (Only mail-in applications) $ 1.50 <br /> 4. TOTAL PERMIT FEE (add lines 1-3 above) � <br /> The undersigned hereby applies to the City of Orono for issuance of a Utility Permit, agrees to <br /> do all work in strict accordance with the ordinances of the City and the regulations of the State <br /> of Minnesota, and certifies that all statements made on this application are complete, true and ° <br /> conect. <br /> Signaturc of Applicant• <br /> � z�� L�Lz---��iyz.._--� Dare: �� r' 9 . <br />