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� CITY OF ORONO APPLICATION FOR UTILITY PERMITS�(2 2 37 <br /> '� ..�- r <br /> Bog 66 (2750 Kelley Parkway) SEWER/WATER <br /> Crystal Bay, MN 55323 � <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 by <br /> return 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 pernut 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 Departrnent(249-4600)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 <br /> Department. Issuance of a permit does not grant this approval. I <br /> 7. All work must be done in accordance with State Code requirements. <br /> 8. All work must be inspected before it is covered. Ca11249-4600. <br /> 24 hour notice required. <br /> JOB SITE ADDRESS: �-� ��'t� ����— <br /> , <br /> Occupancy Type: �'— Residential Commercial <br /> Owner's Name: Phone Number: ' <br /> Mailing Address: City: 7ap: <br /> Contractor's Name: l,c�;c ��-,� �-��— Phone Number: �yG-lY f�' i <br /> Mailing Address: �v .��y,� �/f City: :S%• .rs��yY.����,y.7ap: ,ss��s '� <br /> PERMIT TYPE <br /> Municipal Sewer Connection ($35.00 per stub) $ <br /> pipe size�inches; material Schedule 40 air tested; cast iron `; <br /> SAC Charge ($1,050.00) must accompany all sewer permit applications unless prepaid. If not �; <br /> prepaid, a sewer connection permit will not be issued. <br /> �� <br /> Municipal Water Connection ($35.00 per stub) $ '; <br /> pipe size inches; material copper; other � i; <br /> WATER METERS must be picked up and paid for at City Hall. �, <br /> (5/8" meters= $130.00; 3/4" meters= $180.00; 1" meters= $240.00) ; <br /> Separate Plumbing Permit issued for water meter. ` <br /> Water meters must be set and sealed by Orono Water Department(249-4600) upon completion <br /> of ineter installation. <br /> REQUIRED minimum 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 Surcharge of$.50 per pernut must be ;' <br /> included for each well,sewer and water connection permit requested. I <br /> 3. Posta,ge & 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 do <br /> all work in strict accordance with the ordinances of the City and the regulations of the State of <br /> Minnesota, and certifies that all statements made on this application are complete, true and correct. <br /> _� <br /> Signature of Applicant: �� �=� Date: %� �--��' <br />