Laserfiche WebLink
CITY OF ORONO APPLICATION FOR UTILIT`� PERIO�IITS <br /> Box 66 (2750 Kelley Parkway) SEWER/WATER � � <br /> ' Crystal Bay, MN 55323 .( ��'� <br /> � <br /> ' GENERAL 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 by <br /> 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 pernuts may be issued to licensed contractors only. <br /> 6. Contact the Public Works Departrnent(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. Ca11249-4600. . <br /> 24 hour notice required. <br /> JOB SITE ADDRESS: � � ��r��� �- ��4 S C"�' I��� � <br /> Occupancy Type: �_�tesidentia Commercial <br /> Owner's Name: ,���f�:���c� �y � �" "� `;`' PhoneNumber: <br /> Mailing Address: City: 7ap: <br /> Contractor's Name: r:�c'S��>�-1,�; �::�.ti. PhoneNumber: � -:� � ; <br /> Mailing Address: G �;r:f � . ��<� ��; City: L c,� :�r 7ap: j S ` <br /> PERMIT T'YPE <br /> Municipal Sewer C9nnection ($35.00 per stub) $ <br /> pipe size ��t inches; material � Schedule 40 air tested; cast iron <br /> SAC Charge ($1,050.00) 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 stu�) $ <br /> pipe size �T- inches; material y�;_ copper; other � <br /> WATER METERS must be picked up and paid for at City Hall. <br /> (5/8" meters = $130.00; 3/4" meters= $180.00; 1" meters = $240.00) <br /> Separate Plumbing Permit issued for water meter. <br /> Water 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 Building Code Division Surcharge of$.50 per permit must be <br /> included for each well,sewer and water connection permit requested. <br /> 3. Postage & 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 Pernut, 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 /> i <br /> -�� - � c� <br /> Signature of Applicant: Date: � � ��~ �� / <br />