Laserfiche WebLink
_ <br />.._:�._. ._: _ .�_ _ . . _ _ _. --. :. _ _ = _ <br /> _� t._ ; ., .. , <br /> . G�ITY OF ORONO APPLICATION FOR DTILITY PERMITS , <br /> � Box 66 (1335 So Brown Rd) SEWER WATER <br /> Crystal Bay, MN 55323 <br /> *************************************************************************** <br /> i: You ma�yt pply�or 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. <br /> Pernnit cards will be sent by return mail the same day the application is received. <br /> 3. Peimits are nat valid imtil yoRi reoeive a pe�it card. <br /> 4. Work must not begin unless the permit card is available on the job site. <br /> 5. Utility oonnection permits may be issued to licensed contractors only. <br /> 6. Contact the Public Works Departme.nt (473-7357) for utility stub as-built locations. <br /> DO NOT ExCAVATE IN ANY STREE`I' AND DO NOT TAP ANY MAIN without express approval of the <br /> Public Works Department. Issuance of a permit does not grant this approval. <br /> 7. All work must be done in accordance with State Code requireirtients. <br /> 8. Al1 work must be inspected before it is covered. Call 473-7357. <br /> 24 haur mtioe required. <br /> ********************************************************�****************** <br /> JOB SITE ADDRESS: ��' ��- I U��� <br /> Occupancy Type: 1/`�esidenti Commercial <br /> OWNER`S NAME: � � �/ �� L -�� Phone No. : <br /> Mailing Address: / _� City: <br /> CONTRACTOR'S NAM$: ��`��,Z ��wl�/�-"� B u s . P h o n : � ' � ��;Z � <br /> Mailing Address: � City: Zip: � '�`/,v..�-� <br /> *********************************************************** ************* <br /> __--�- - <br /> �ss o�-b PffitMIT TYPE AND FEE CALCDLATION <br /> MIINICIPAL SEWER CONNECTION ($34-:-00 per stub) $ <br /> pipe size inches; material PVC (on sand fill) ; cast iron <br /> SAC Charge ($700.00 ) must accompany all sewer permit applications unless <br /> prepaid . If not prepaid, a sewer connection permit will not be issued. <br /> ;3S� c—c> <br /> MIINICIPAL WATER CONNECTION ($�-�-$@'per stub) $ <br /> pipe size inches; material copper; other <br /> WATER METERS must be picked up and paid for at City Hall. <br /> (5/8" meters = $133. 00; 3/4" meters = $181.00; 1" meters = $235. 00) <br /> Water meters must be set and sealed by Orono Water Department (473-7357) <br /> upon campletion of ineter instal lation. <br /> REQUIRED minimum setbacks from drainfield and septic tanks = 75' <br /> REQUIRED setback from sewer line = 20 ' <br /> *********************************�***************************************** <br /> 1. Subtotal of above permit requested $ <br /> 2. State Surcharge .50 <br /> The State Building Code Division Surcharge of .50 per permit must e <br /> included for each well, sewer and water connection permit requested. <br /> 3 . Postage � Handling (Only mail-in applications) $ 1.50 <br /> 4. TOTAL PERMIT FE13 (add lines 1-3 above) $ <br /> *************************************************************************** <br /> __. <br /> The undersigned hereby applies to the City of Orono for issuance of a Utility Permit, <br /> agrees to do all work in strict accordance with the ordinances of the City and the <br /> regulations of the State of Minnesota,�.an`d ertifies that all statements made on this <br /> application are complete, true and �ect. <br /> i <br /> Signature of Applic , _ ate���/��y-�,2�'_� <br /> � <br />