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CITY OF ORONO � 6124730510 01/15/97 10:55 � :02/02 N0:844 <br /> � `�CXTY Qr� nRG1NU AkYLII>A'r1uN �r�ux u l�1,i t Y 1•r.:xm.rt e <br /> Aox 66 (;2'��U Keltey Parkway) S�WEK/WATER <br /> � �rysta�Bvy, M.N 55323 <br /> � � �„°I � <br /> �; .�'N�I�A�1;1NF��1lUN <br /> 1. Ynu may Apply for utility p�nnits by mail or in person ut the Gity offiee�_ <br /> 2. Mai�ed i.�applic�tinns ur�subjer.t tu the posta�e end handling fc�s st�own belnw, Permi�cards will be eenC by <br /> caRirn m�fl the asme day tbn epplicecion is received. <br /> 3. Permits ar.e unt valid undl you receive e permlt card. <br /> 4. Work mu�t nqt bcgin unleKs the petmit c�.rd is avnilalale on the jab Aita. <br /> g; Urilicy connection permits may be issue�l ro licensed con.tractors only, <br /> 6. C.��►t.tact t��e 1'ublic Works Depar[tnent(473-714?)for utility stub as-built locations. DC)NnT FXCAVA'I'E: <br /> iN A�FX S'I'It�:�T AND UO N�'T T'AP ANY N!A'!N without express epproval of thB Public V1/orks <br /> f)ep�tmcnt. lsauance of a pcTrnit does not gr�nt this Rpp.rnvn�, <br /> '7. AU work must bc ct�ne in occordahce with State Gode regulrement9. <br /> B, All wbrk awst be in5�tcted hcfore it is covored, Call 473•7357. <br /> Z4 hour natice roqui�ed. <br /> .fOASIT�.Ann12Fs5:_3 8 s�o. sh o�L,`�u�. �r . - <br /> Qcc�ipancy Type: ResidentiAl fC�mmerci�l <br /> nwner'� Neme: ��,.ti co PhoneNumb�r: <br /> 11viHlling Avdresd�: = ---- � City:� ?�p: <br /> Contraecur'� ,Nam�: -,��.,�,G f�•- •�i�,�. Yhone Numbor: 1%/-7aio � <br /> 1V�qi�ln�A.ddre�s'7��'lv �f/AJ�c /�iG�� .l'� City: �'• /� 7�x,� <br /> PEB��."�:�YP� <br /> 11�lunirlp�l �ewer t:onnoction ($35.00 rer stub) �_�y_.-_ -�--- <br /> pipe sir� inches;: inaterial -w-•--_FV�; (on sand till); __ cast iron <br /> �AC(;f�r�r�e($90U.00')must�u:c��mpany all sew�r pem�.it applica�ions unlcss prepaid. if not prepeid, <br /> a aewer cunnecti�n�crmit will not be ir�yued, <br /> M4�►icip�tl Watc�`Conncctir►n (535.4U per stub) S `���/60 <br /> pipe size _ inch�s; material _copper; c�tl�er __�__,..�....._----- <br /> WA'1'�lZ M.ETF:RS must he picked up ancl aid for at Cit t-iall. <br /> (S/R" l�eters = $13��.00; " meters^ $191.0 ; 1" msters II $�47.OQ) <br /> SC{�erate Plwnbing Petniit is�ued 'c�r water m�t�r. <br /> Vlrntcr mctere mu�t bc Ket snd�caled by�runo Water I�epurtment(473-7357)up�n�ompleti�n <br /> of inet�r ihats�llstlon. <br /> R�:QLJIRr:A minimt.im setbacks from drainfield and septic tank�-75' <br /> It�?C�LJIRFi)setback from sawer lin�- �0' <br /> �' .RM� F 'E AL.GU�' ION <br /> 1.. Suk�tc�fal ot above permit rec�ua�ted $ . _ <br /> 2. Sta.te Su«har¢� � �-� <br /> 'Tho Stare�u.ilding C'ode I)f�tsfon Surchprge oPS.SO pmr permit n�uyr be <br /> includeci fot eneh we11, sewer and water co�neetion permit r�quested. <br /> 3. �,flyta,�e& ���diincc (Unly mail-in a�plicatiorts) S 1.50 <br /> 4: TU'T'A[.. 1'ER.h�IT1• F�:E (add lines 1-3 ab.ov�) $ _._,__ � ,.,. <br /> Thd undersi�ned herehy i�ppli,es to the City �f CUrono fc�r issi�ancc of a Utility Permit, agreos to do <br /> �ll wc�rk in �tr�ct ac:cordunCe with the ordir��tnces of ih� City ancl the reg4lations of the State af <br /> [ViinneAots,and certifies that alt 9tate.m nt�mado an this a�plication ar�complete,truo and correct, <br /> 'Signoture of�p�►licutit: �,�u,� _T ,^ Dat�:�1�5 '�� <br />