Laserfiche WebLink
w <br /> � CITY OF ORONO APPLICATION FOR UTILITY PERMITS � <br /> Box 66 (2750 Kelley Parkway) SEWER/WATER ���j-S- � <br /> Crystal Bay, MN 5�323 � .y, �,� <br /> � <br /> GEIVERAL INFORMATION <br /> 1. You may apply for 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. Permit cards will be sent <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 /> 6. Contact the Public Works Department(249-4600)for 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 /> Department. 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 249-4600. <br /> 24 hour notice required. <br /> JOB SITE ADDRESS: f -�' s' S ��2` ���'�� <br /> Occupancy Type: Residential Commercial <br /> Owner's Name: ,: .-��n- `��--�yt Phone Number: <br /> �Iailing Address: �� � �ti-z �-�— City: 7ip: ��Q <br /> Contractor's Name: ����yu '��-� i^� ��Phone Number:�/�' y /� �/�¢�e % (9r'� <br /> Nlailing Address:�/ ,7 c� 1/�-�-.�a` City: '>�-� ,i-��� 7ip: ��" J <br /> > <br /> PERMIT TYPE <br /> Municipal Sewer Connection ($35.00 per stub) $ <br /> pipe size inches; material Schedule 40 air tested; cast iron <br /> SAC Charge (2000 rate $1,100.00) must accompany all sewer permit applications unless prepaid. <br /> If not prepaid, a sewer connection permit will not be issued. <br /> Municipal Water Connection ($3�.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(249-4600)upon completion <br /> of ineter 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 $ <br /> 2. State Surchar�e $ .50 <br /> The State Buildin�Code Division Surchar�e of$.50 per permit must be <br /> included for each well, sewer and water connection permit requested. <br /> 3. PostaQe & Handlin� (Only mail-in applications) $ 1.50 <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 <br /> all work in strict accordance with the ordinances of the City and the regulations of the State of <br /> Minnesota, and certifies that all statements made on this application are complete,true and correct. <br /> ��� � /��- � : �� <br /> Signature of Applicant: ������ -���-- Date: <br />