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_ , <br /> _. _ _, _ _ : <br /> • CITY OF ORONO APPLICATION FOR DTILITY PERMITS a <br /> Box 66 (1335 So Brown Rd) SEWER WATER <br /> Crystal Bay, MN 55323 ' <br /> *************************************************************************** ,: <br /> I: You majy�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 /> Permit cards will be sent by return mail the same day the application is received. <br /> 3. P�.anits are n�t va.lid umtil you reoeive a �*Th;t 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 /> 6. Contact the Public Works Department (473-7357) for utility stub as-built locations. <br /> DO NOT �CAVATE IN ANY SIREET AND DO NC7r TAP ANY MAIN without express approval of the <br /> Public Works Departsnent. 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. Cal 1 473-7357. <br /> 24 haur natioe requirec3. <br /> **********************************************************�**************** � <br /> f � T �-_�� ;�� f��'�- � ���u ��;'��5�/'%>r�'� ? <br /> JOB SITE ADDRESS: C / <br /> Occupancy Type: G%" Residential Commercial <br /> OWNER'S NAME: ��j c� J;�=�l ,/L�'��iZ����il,j Phone No. : <br /> Mailing Address: City: <br /> CONTRACTOR'S NAML: l- '��� L 1�-� %�'_'��� Bus. Phone: `���� ������-�' <br /> Mailing Address: City: / �! Zip: �:�"�;'��- <br /> **********************************************************************�**** ` <br /> ___,_. _ <br /> PERMIT TYPE AND F$E CALCIII,ATION � <br /> MIINICIPAL SEWER CONNECTION ( $30 . 00 per stub) $ � � '�r� ' <br /> pipe size // inches; material �PVC (on sand fill) ; cast iron <br /> SAC Charge ( $700.00 ) must accompany all sewer permit applications unless 'f <br /> prepaid. If not prepaid, a sewer connection permit will not be issued. <br /> MIINICIPAL WATER CONNECTION ( $30 . 00 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 completion of ineter installation. <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 be - <br /> included for each well, sewer and water connection permit requested. <br /> 3 . Postage � Handling (Only mail-in applications) $ 1. 50 <br /> 4. TOTAL PERHiIT FEE (add Iines 1-3 above) $ <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, a,�d ce�ifies that all statements made on this � <br /> application are co�lete, true and.�corr�'. � <br /> �� / -� ��� ,� c� - , i <br /> �� <br /> i � ' - ,/.�- , <br /> Signature of Applicant: ' �y_-� �E-=� Date: �� '� `�` � � ? <br /> c <br />