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2004-P07575 - sewer connection
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2004-P07575 - sewer connection
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Last modified
8/22/2023 4:53:24 PM
Creation date
1/26/2016 11:51:18 AM
Metadata
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x Address Old
House Number
776
Street Name
Brown
Street Type
Road
Street Direction
North
Address
776 Brown Road North
Document Type
Permits/Inspections
PIN
3411823110001
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(Updated 5/3/02) <br /> CITY OF ORONO APPLICATION FOR UTILITY PERMITS <br /> Box 66 (2750 Kelley Parkway) SEWER/WATER& SAC <br /> Crysta�.Bay, MN 55323 <br /> GENERAL INFORMATION <br /> 1. You may apply for utility pernuts by mail or in person at the City offices. <br /> 2. Mailed in applications are subject to the postage and handling fee shown below. Permit cards will be sent by return mail the same day <br /> the application is received. <br /> 3. Permits are not valid until you receive a permit card. <br /> 4. Work must not begin unless the pernut card is available on the job site. <br /> 5. Utility connection pernuts may be issued to licensed contractors only. <br /> 6. Contact the Public Works Department(952-249-4600)for utility stub as-built locations. DO NOT EXCAVATE IN ANY STREET AND <br /> DO NOT TAP ANY MAIN without express approval of the Public Works Department. Issuance of a pernut 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(952)249-4600,24 hour notice required. <br /> JOB SITE ADDRESS: 776 �Or��► I�r�i.i1 �- 1�e� <br /> Occupancy Type: � Residential Commercial <br /> Owner's Name:�;ck /3��s��•ti Phone Number: y.S3—�y� t��`3l <br /> Mailing Address: ,�. c�. City: prior� Zip: <br /> Contractor's Name: ���5 e f�,�,�s , iac. Phone Num er: �G� ��9'/d�i 5� <br /> Mailing Address: /3S! C�� d�,l $3 City: o t d.� Zip: ������ <br /> PERMIT TYPE [�Connections ❑Repairs ❑Disconnect (Check One) <br /> SAC Charge (2002 rate $1,200.00) $ (Set Rate) <br /> Sac Charge must accompany all sewer permit applications unless prepaid. � �O� <br /> (If not prepaid, a sewer connection will not be issued) !}� ��b <br /> Municipal Sewer Connection/Disconnect/Repair ($35.00 per stub) $ � 'L�\ <br /> pipe size t'/ti" inches; material Schd 40 air tested; cast iron p�\ <br /> NTunicipal Water Connection/Disconnect/Repair ($35.00 per stub) $ <br /> pipe size inches; material copper; other <br /> WATER METERS must be picked up and paid for at City Hall. <br /> `Vater meters must be set and sealed by Orono Water Department <br /> (952-249-4600) upon completion of ineter installation. <br /> REQUIRED minimum setbacks from drain field and septic tanks= 7S <br /> REQUIRED setback from sewer line=20' <br /> PERMIT FEE CALCULATION <br /> 1. Subtotal of above permit requested $ <br /> 2. State Surchar�e $ .50 (Minimum) <br /> The State Building Code Division Surcharge of$.50 per pernut must be <br /> included for each well,sewer and water connection permit requested. <br /> 3. PostaQe & Handlin� (Only mail-in applications) $ 1.50 (Mail In Only) <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, agrees to do all work in strict <br /> accordance with the ordinances of the City and the regulations of the State of Minnesota, and certifies that all statements <br /> made on this application are complete, true and correct. <br /> � <br /> Signature of Applicant` Date: /G r 7—D/ <br />
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