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<br /> r� CITY OF ORONO APPLICATION FOR UTILITY PERMITS � ` ,.�
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<br />#° ' Box 66 (2750 Kelley Parkway) SEWER/WATER � � "� °
<br /> Crystal Bay, MN 55323 �j�l ' �;���� ;
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<br /> GENERAL INFORMATION
<br />�� ���� '''' 1. You may apply for utility permits by mail or in person at the City offices. �':��`"�����;
<br /> �. �` .4' � 2. Mailed in applications are subject to the postage and handling fees shown below. Permit cards will be sent by :� �
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<br /> `" v''�` return mail the same day the application is received. ' �
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<br /> 3. Permits are not valid until you receive a permit card. , k �a
<br /> - 4. Work must not begin unless the permit card is available on the job site. - -� �4 �' " ��� , '�� { -'
<br /> . 5. Utility connection permits 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 t t'�,�,�.;
<br /> -�-:� IN ANY STREET AND DO NOT TAP ANY MAIN without express approval of the Public Works < <�,��
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<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. � x ,^ � ,, -� , �;
<br /> _� 24 hour notice required. ,�,-" °��� ,� � �` ��r` �� ',� ;�,�J� *�
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<br /> JOB SITE ADDRESS: i�y��I '!�'��/,�=��- '�����°
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<br />� Occupancy Type: �� Residential Commercial ��' �
<br /> Owner's Name:_�,',.� �-:i�L<�� - Phone Number: `� ` h
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<br /> .�,�, Mailing Address: s��r�— City: 7�p: ' �,�
<br /> � Contractor's Name: �•''�c%�-- i---��– Phone Number %r' %� � -- '"'�r `
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<br />� � Mailing Address: �--'� r���� �i�` City:�' _�; -- 7ip: - f �> �
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<br />� PERMIT TYPE ��� "
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<br /> Municipal Sewer Connection ($35.00 per stub) $
<br /> pipe size ��� inches; material'��- �� Schedule 40 air tested; cast iron ��`� _��
<br /> 4 Y #r's� SAC Charge($950.00)must accompany all sewer permit applications unless prepaid. If not prepaid, ,�� � ��
<br />'`� ` a sewer connection permit will not be issued. ��;�� �
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<br /> Municipal Water Connection ($35.00 per stub) $ ,:';�� , �`'�
<br /> } '�� pipe size inches; material copper; other '�•�-�� �
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<br /> � �*`` WATER METERS must be picked up and paid for at City Hall. `' , �
<br /> � z �y (5/8" meters = $139.00; 3/4" meters= $191.00; 1" meters = $247.00) ' ��l �� ��` ��
<br />� Separate Plumbing Permit issued for water meter. � ` ���
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<br /> Water meters must be set and sealed by Orono Water Department(473-735'�upon completion �� � u ;�
<br /> of ineter installation. �r= �`` �:
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<br /> '� �` REQUIRED minimum setbacks from drainfield and septic tanks= 75' ��
<br /> ; REQUIRED setback from sewer line = 20' � Y ' ' *
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<br />�a �3 PERMIT FEE CALCULATION :�': `� � '� �:� �``�'"
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<br />°� 1. Subtotal of above permit requested "' . -�' � � $ -� r�tir:
<br /> g � 2. State Surchar�e $ .50
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<br /> r `' The State Building Code Division Surcharge of$.50 per permit must be x�����
<br />�,` �� included for each well,sewer and water connection permit requested. ��n�`A��:`
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<br />; ' 3. Postage & Handlin� (Only mail-in applications) $ 1.50 �-;�� ��-�
<br />�'' 4. TOTAL PERMIT FEE (add lines 1-3 above) $ �� �`�
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<br />� '`? The undersigned hereby applies to the City of Orono for issuance of a Utility Permit, agrees to do j� � £
<br />�� all work in strict accordance with the ordinances of the City and the regulations of the State of '"������
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<br />� ,�;: Minnesota, and certifies that all statements made on this application are complete, true and correct. �`t����
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<br /> Signature of Applicant: .�� ����-���–C' Date: ��� _�',% �`-�, ��;
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