Laserfiche WebLink
•" CITY OF ORONO APPLICATION FOR UTILITY PERK" TS <br />;;4 42S <br />Box 66 (2750 Kelley Parkway) SEWER/WATER <br />Crystal Bay, MN 55323 <br />GENERAL INEOR-TATION <br />you may apply for utility permits by mail or in person at g e <br />1 <br />2. Mailed in applications are subject to the postage and handling fees aiil�v .. v. Permit cards will be seat <br />by 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 permit card is available on the job site. <br />5. Utility connection permits may be issued to licensed contractors only. <br />for <br />ty stub as -built locations. DO <br />EXCAVATE <br />6 Contact the <br />STREET AND DO NOTTAPANY MAIN rwithout express app oval of theTPublic IN ANY c Works <br />Department. issuance of a permit does not grant this approval. <br />7. All work must be done in zccordance with State Code requirements. <br />8. All work must be inspected before is covered.Call 7357.ura required. <br />�� <br />JOB SITE ADDRESS: J <br />Occupancy Type: x Reside <br />iAi <br />Owner's Name: H� 1(5 <br />n <br />Mailing Address: 13 " C: 0 e (A C.;-- <br />Contractor's Name: <br />Mailing Address: <br />I CA <br />Commercial <br />Prone Number: <br />City:01( - t' <br />Prone Number: <br />1 <br />City: L11 t2 <br />PERMIT TYPE $ <br />Municipal Sewer Connection (S35.00 per stub) cast iron <br />pipe size inches; material PVC (on sand fill); <br />permit applications unless prepaid. If not <br />SAC Charge ($800.00) must accompany all sewer <br />prepaid, a sewer connection permit will not be issued. <br />Municipal Water Connection ($35.00 per stub) other <br />pipe size inches; material copper; <br />WATER METERS must be picked up and paid for at City Ha;l. <br />(5/8" meters = $133.00; 3/4" meters = $181.00; 1" meters = $235.00) <br />Separate plumbing Permit issued for water meter. <br />Water meters must be set and sealed by Orono Water Department (473-735T, 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 FEE CALCULATION $ <br />1. Subtotal of above permit requested $ .50 <br />2. State Surcharge <br />The State Building Code Division Surcharge of s.50 per permit must be <br />included for each well, sewer and water connection permit requested. $ 1 5(1 <br />3. Postage & Handling (Only mail -in applications) $ <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. to <br />do all work in strict accordance with the ordinances of the City and the regulations e. State <br />of Minnesota, and certifies that all statements made on this application are complete, tn-e and <br />correct.xr�, - <br />Dale: <br />Signature of Applicant: .(�� <br />