Laserfiche WebLink
c;rr Y u��� uuu�v u !�r��.i�A�r�uiv r u� u�ri�,ri�Y r�:xlvirr5 �. <br /> Box 66 (2750 Kelley Parkway) SEWER/WATER <br /> Crystal Bay, MN 55323 <br /> s <br /> ` GEN�RAL INFORMATION <br /> 1. You may apply for utility permits by mail or in person at the City offices. <br /> r 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(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. 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 473-7357. �' <br /> 24 hour notice required. <br /> �/ ,,� �� <br /> JOB SITE ADDRESS: � �j Ci U� (�--c��._�-�-- ,/ ��` /�-�2- <br /> Occupancy Type: . ` Residential Commercial l.�7/ - �� �� <br /> Owner's Name: '-,��-z6-n-�- %��-c��-�-- PhoneNumber: �_j �f— /�{ 7�' <br /> Mailing Address: 2 �;p a z-�-- .-� r,�C City: �,�-z � 7ip: <br /> Contractor's Name: �,, �-L-E-h /�-���- �oneNumber: " � - '/_�' v <br /> Mailing Address: City: , 7ip: �j 5' �Z �7' <br /> PERMIT TYPE <br /> Municipal Sewer Connection ($35.00 per stub) $ <br /> pipe size � inches; material PVC (on sand fill); cast iron <br /> SAC Charge ($800.00) must accompany all sewer permit applications unless prepaid. If not <br /> prepaid, 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 �}�s�ed up and paid for at City Hall. �/ <br /> (5/8" meters = $133.00; � 3/4" meters = $181.00; 1" meters = $235.00) �^ :�- <br /> Separate um ing Permit issued for water meter. " <br /> Water meters must be set and sealed by Orono Water Department (473-7357) upon <br /> completion 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 Building Code Division Surchazge of$.50 per permit must be <br /> included for each well, sewer and water connection permit requested. <br /> 3. Posta e & 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 <br /> do all work in strict accordance with the ordinances of the City and the regulations of the State <br /> of Minnesota, and certifies that all statements made on this application are complete, true and <br /> correct. <br /> � � _� <br /> Signature of Applicant. �-��-e ��L� � � `� <br />