Laserfiche WebLink
�� C1TY OF URONO APPLICATI�N FOR UTILITY PERMITS <br /> Box 6G (2750 Kelley Parkway) SEWER/WATER <br /> Crystal Bay, MN 55323 ,y h`�� <br /> �� <br /> GGNGRAL INFORMATION <br /> 1. You may apply for utility permits by mail or in person a[the City offices. <br /> 2. Mailed in applications are subject to the postage and handling fees shown below. Permit cards will be sent by <br /> return mail the same day the application is received. <br /> 3. Pcrmits 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 on(y. <br /> 6. Contact the Public Works Department(473-7357)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. [ssuance 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 473-7357. <br /> 24 hour noticc requircd. <br /> JOBSIT�ADllItESS: 2`7 y� Cas c o �f� <br /> Occupancy Type: Residential Commercial - <br /> Owner's Name: C � i e v` Phone Numbcr: ' <br /> Mailing Address. � City-��r�++, v 7�p: <br /> Contractor's Name: � � e /G e c y ,`c� Phone Number: (rJ j �2 v <br /> M�iling Address: S Os� 2 2 C� S � � City: �N►nin�• n 7�p: SS42 <br /> PERMIT TYP� <br /> Municipal Sewer Connection ($35.00 per stub) $ <br /> pipe size inches; material PVC (on sand fill); cast iron <br /> SAC Charge($850.00)must accompany all sewer pennit applications unless prepaid. If not prepaid, <br /> a sewer connection permit will not be issued. <br /> Municipal Water Connection ($35.00 per stub) $ <br /> pipe size inches; material copper; other <br /> WATER MI;TERS must be picked up and paid for at City I�all. <br /> (5/8" meters = $139.00; 3/4" meters = $191.00; 1" meters = $247.00) <br /> Separate Plumbing Permit issued for water meter. <br /> Water meters must be set aud sealed Uy Orono Water Department(473-7357)upon completion <br /> of inetcr installation. <br /> REQUIRED minimuln setbacks froin drainfield and septic tanks = 75' <br /> REQUIRED setback from sewer line= 20' <br /> I'F,RMIT F�i�, CALCULATION <br /> l. Sublotal ol�abovc percnil rcyucsled $ <br /> 2. State Surchar�e $ .50 <br /> T'he State f3uilding Code Division Surcharge of$.50 per permit must be <br /> included for each well, sewer and water connection permit requested. <br /> 3. Posta�e & �Iandlin�(Only mail-iii applications) $ 1.50 <br /> 4. TOTAL I'LRMIT FEE (add lines 1-3 above) $ <br /> "1 he ui�dersigned 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 /> Si nature of f1 licant: � . Date: � � �� <br /> � �P <br />