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. CITY OF ORONO APPLICATION FOR U'I'ILII'Y PERMI'T'S <br />Box 66 (2750 Kelley Parkway) SEWER/WATER <br />Crystal Bay, MN 55323 <br />G F: N F.R A I. INFORMATION <br />I. You may apply for utility Permits by mil or in icrson at the City offices. <br />2. Mailed in applications are subject to the Postage and handling fees shown below. Permit cards will be sent <br />by return mail the same day me application is received. <br />3. Pmnit are not valid until you receive a permit card. <br />4. Work must not begin unless the permit card is available on the job site. <br />5. Utility connection permits nuy be issued to licensed contractors only. <br />6. Contact the Public Works Dcpartmcni (473-7357) far 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 />Depanrncnt. 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. <br />24 hour notice required. <br />JOB SITE ADDRESS:_ <br />_ <br />Occupancy Type: <br />Residential Commercial <br />Owner's Name <br />Phone Number:_ <br />Mailing Address: <br />_ <br />City:__ Zip: <br />Contractor's Name: <br />PhoneNuimba: <br />Mailing Address:_ <br />City: Zip <br />PERMIT TYPE <br />Municipal Sewer Connection ($35.00 per stub) $ <br />pipe size inches; material PVC (on sand fill); cast iron <br />SAC Charge ($850.00) must accompany all sewer permit applications unless prepaid. If not <br />prepaid, a sewer connection permit will not be issued. <br />Municipal Water Connection ($35.00 per stub) 5 <br />pipe Sire _ 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" teeters = $235.00) <br />Separate Plumbing Permit issued for wa --r meter. <br />Water meters must be set and sealed by Orono Water lkpartnsent (473-7357) upon <br />completion of meter installation. <br />REQUIRED minimum setbacks from drainfield and septic tanks = 75' <br />REQUIRED setback from sewer line = 20' <br />PERMIT FEF CALCULATION <br />1. Subtotal of above pcniiit requested 3 <br />2. Slate Surcharge 3 5t1 <br />Tile State Building Code Division Surcharge of $.So per pernil must be <br />included ler each well, sewer and water connection permit requested. <br />3. Postage & handling (Only mail -in applications) S 1.50 <br />4. TOTAL PERMIT PEE (add lines 1-3 above) 3 <br />The undersigned hereby applies to the City of Orono for issuance of a Utility Permit, agrees ht <br />do all work in strict accordance with the ordinances of the City and the regulations of the State <br />of Minnesota, and certifies than all statements made on this application are complete, true and <br />correct. <br />Signature of Applicant:_ DLL:: <br />