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4. <br />: 5. <br />4. <br />CitYofOROXO <br />GENERAL INFORMATION <br />Applleatl**/;f«>r <br />Utility Permits <br />V <br />■•■. .t:/ <br />tew«r water W€ll <br />Texmit <br />r«ii My i§‘i tUiUt^ rttPii* by Mi/ cx i« jpciaoh at tht CUy e<fic«*. <br />U^Ud im wUcaUcii* AXt Aubjtct to tht rcAtayi and handtUs jcc4 ^^lOlCll beta*:, <br />uttuxn Mi/ tkt Aomt day tht flpr<*ca/iOR ii Rtctivcd, <br />P/RMITS m N(JT VAIIP JiWTIt you R£CfIl'f A rf£«IT CAW <br />VCKX uusr kCT B£CI« UWIESS THf F/RMIT CAPP IS AyAItABU CH TME JOB SITE. <br />U/ifify coRRCC/ioR peti*i/4 may tt inutd to /icefi^cd conXxaetoxA cn/ti. <br />po"ior EXCAPATE^lS^Aly^STW toT^TAP a Sv ^WA iS*^^^ e*pie*i arP^.ovai oj the Pt/b/i <br />SSggj <br />tiSUAMCi OF A rtRMIT POtS A’CT CRAWI THIS APPRORAl. <br />AU *CR* MUST 8£ PORE IR ACCORPAVCE U'lTH STATE COPE RECUISE«ERTS.-QROWO' <br />INSTRUCTIONS Ccnpitn at: Utr: c« EAEA appEieatEa*. Co»put« tAe <*€. $40" <br />--------------------—IWCOUPIETI APPUCAT.OVS tJU ROT 8E PROCESSEP. tt you havt ^uttUeni. catt 47i~1ii7. <br />WALK-IN PERMITS <br />MAIL-IN PERMITS <br />App£{/ at Clttj , <br />EiicEoic ijec - h\atZ to: <br />1335 South BfiOim Road iCty. Rd. 146} <br />P.O. Sox. 66, Caijitat Saij, h\n. 55323 <br />JOB SITE <br />Occupancy Type* <br />ADDRESS ^t^OVmER <br />t ^ RcAidf«/ifl/ ____ Comme.xcUt Othext ----------------------------------------------------Jl------—-------- <br />___ X*44f4«9 occupied 6uiEdi«3 ____ Me»' con^CeucTcou, not yeC occupied crcy / <br />Contractor . ■_____ Telephone No. <br />Mailing Address <br />City License No. <br />Wcc -</^ /Ck id <br />Master Plumber's State License No. <br />PERMIT TYPE & FEE CALCULATION <br />MUNICIPAL SEWER CONNECTION (JTO.OP pee *<uk ptue t.SO state SuecAoese • tte.59 eacAl <br />. pipe Aize ___incfccA; mattxi&l rVC (on Aand iitt);coAt Vion; othtx <br />APO FOR WC SAC CHARGE* 4//5/u«i/ X uni/4 <br />SAC MUST ACCOHPAWy ALL SEWER TERHIT APPIICATIOWS unliAA phtpaid, J£ pxtpald, 4hc«i ne£tne«Ct toi <br />Kicetpt U9o __ _ _ _ Sui/difig VtxmU Wc. _ _ Gtntxal Pixmit Ho. _ _ _ _ <br />Permit <br />SAC <br />HOTlSr li A Atpaxatt ptumbiny ptKmU muAt be cbtaAnidJox any enA4.dt ckanjeAo <br />t] CUaneatA r^uAt bt inUatUd at ang/t fccnrfi and toexy ISO iett oi tun. <br />3) EtiA/ing Atptic tankA rtuAt be purptd and iitltdn <br />MUNICIPAL WATER CONNECTION (4eV.C0 pm Atub pUa I.$0 stalt Suxchaxgt • IZC.SO cacM <br />pipe Aizt InchcA; matcxiat coppct, type _ _othtx^incfccA; matexiat __coppct, type <br />APP FOR WATER METER* 5/E- • $60,00; U*** • 515.00 METERS MOST BE PICXEP UP AT CITX HAIL. <br />bOrtSi n UiUxA may be puXchaAcd by the contxaztox ex by the pxopexty ovcntx <br />Permit <br />Meter <br />El Wa/ce pctni/A include inApection iox Mc/ct inAtatlation, <br />be obtained (ox any o/Aet inAide p/umbing changtA, <br />3|. CuAb Atop muaC be Aft j/uAb to gaound iutjcce. <br />4) WATER WUST WOT BE TURWEO OW UMTU CITV SEALS METER • CALL WHEW REAPV <br />A Atpaxatt plumbing ptxmit nuA/ <br />PRIVATE VJELL INSTALLATION (^eo.oo ptx joL pluA 1.50 state Suxtkaxge <br />i/" <br />eep/aceiHrnt urc// ____ xtpaix eeiAting u>ett; csAing *ire» __cAecki ntuf H*e// <br />5E0.50 caekl $ Permit <br />ilickcA <br />WOTtSi I) A icpata/e p/uabifig pexmit muAt be obtained ^ox any inside p/umbing cKanqcA. <br />E) Requited nini«uM te/backip ixomt dxainiietd - 75 Jeet iep/ic tank ‘ 50 <ce/ <br />CALL FOR SITE LOCATIOW BEFORE PRIILIWC <br />51 Upon comptttion, CITV MUST BE SCMT A COPy OF THE STATE WELL REPORT <br />state Surcharge Tke state luit<Un$ code VivUien SuecRangc oi St< pea pca.it fia* bee. iaetuded above. <br />.y\^ : - - -— Total Sueekaxge iox combined watex and.Acieet petuiti i4 51.00 <br />Oa att .ailed.ia apptieatioa*. add tbe paataje aad baadtiaj iee $ 1: 06Postage and Handling <br />TOTAL PERMIT FEE <br />V-' <br />The .adea.ijatd hraeby appfir. to the Cttu oj Caoito (loa <br />‘itfl/cwcii/A'wadc'^ on tki4' app/ica(4cn ate cemptete; /tue <br />iiAuance oi a UTJlJTy PERMIT. agxecA to do atl moxb in Atxict <br />af.tke State -ci iUnntAota, and eaxtiiitA. that atl ^ - <br />and eoxxeet, ^