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<br /> CITY OF ORONO APPLICATION FOR UTILITY PERMITS � � � `�''� �
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<br /> Box 66 (2750 Kelley Parkway) � SEWER/WATER �`.;� ��� ���
<br /> - . 5323 �� . �'w�,� ;� � a
<br /> Crystal Bay,MN 5 �,
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<br /> GENERAL INFORMATION
<br /> r 1. You may apply for utility permits by mail or in person at the City offices. �
<br /> 2. Mailed in applications aze 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. ,, :-., �;,
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<br />, 4. Work must not begin 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 Department(473-7357)for utility stub as-built locations. DO NOT EXCAVATE p;��
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<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. , , �;,
<br /> 7. All work must be done in accordance with State Code requirements. ��� `� �
<br /> ` �� 8. All work must be inspected before it is covered. Ca11473-7357. ,����� � ,,, ` , �'� � i��� �+��''''���"�
<br />' 24 hour notice re uired. "'_ '� � ��� ''° � ` �
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<br /> �" JOBSITEADDRESS: �� c�<� ;.� � ��: � y � r- ��_ _ '�,�, h'�
<br /> r� Occupancy Type. Resilential Commercial
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<br /> � - � i� �-, i �-- Phone Number• �< ,� `
<br /> Owner s Name: ( � ,�
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<br /> Mailing Address: City: 7�: �;
<br /> Contractor's Name: ,�,�.J � ` ��� �L ��� � �- 1 Phone Number: ,�,�% L ,�� � {�
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<br /> Mailing Address: � � Cih'' l" � '` ZP�3`T
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<br /> PERMIT TYPE z,� ;;
<br /> { Municipal Sewer Connection ($35.00 per stub) $ �'=� '�` "
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<br /> pipe size inches; material PVC (on sand fill); cast iron �„��� �.f
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<br />� : SAC Charge($900.00)must accompany all sewer permit applications unless prepaid. If not prepaid, � �A ����
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<br /> 1 r � a sewer connection permit will not be issued. �� �
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<br /> ��. Municipal Water Connection ($35.00 per stub) $ �::h�r'�x
<br /> pipe size inches; material copper; other y�A���,�
<br /> WATER METERS must be picked up and paid for at City HaIL r ��� ;�
<br /> (5/8" meters= $139.00; 3/4" meters = $191.00; 1" meters= $247.00) '`' �� ��
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<br /> Separate Plumbing Permit issued for water meter. :�.� ��
<br /> Water meters must be set and sealed by Orono Water Department(473-7357)upon completion t`� ,��,
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<br /> of ineter installation. ��
<br /> REQUIRED minimum setbacks from drainfield and septic tanks =75' ��� "�'
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<br /> REQUIRED setback from sewer line=20' � ,�� ti �: ' '��:�� +�'�
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<br /> PERMIT FEE CALCULATION ' ` ��;`����` ���'�� �
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<br /> 1. Subtotal of above permit requested � $ �
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<br /> 2. State Surcharee � $ � �
<br /> .50 .�:� �
<br /> i � The State Building Code Division Surcharge of$.50 per permit must be �'� '�`�' �'
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<br />, "�' included for each well,sewer and water connection permit requested. T �� � �
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<br /> � .� 3, Postage & Handlin� (Only mail-in applications) $ 1.50 ��� �
<br /> �` 4. TOTAL PERMIT FEE (add lines 1-3 above) $ �4��' ,�
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<br /> ;:. The undersigned hereby applies to the City of Orono for issuance of a Utility Permit, agrees to do ��� � �
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<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. ��:��';;
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<br /> Signature of Appli�catrt�---=-- ` D��� `� �`
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