Laserfiche WebLink
Metadata
Document management portal powered by Laserfiche WebLink 9 © 1998-2015 Laserfiche. All rights reserved.
CITY OF ORONO APPLICATION FOR UTILITY PERMITS <br /> 'Box 66 (1335 So Brown Rd) , ���� SEWER WATER _ <br /> Crystal Bay, MN 55323 <br /> *************************************************************************** <br /> I:- You may�'a ply�or utility permits by mail or in perscn at the City offices. <br /> 2. Mailed in applications are subject to the postage and handling fees showri below. <br /> Permit cards will be sent by return mail the sam�e day the application is received. <br /> 3. Pe.�its are not valid imtil you reoeive a �*�*+�;t 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 Departm�e.nt (473-7357) for utility stub as-built locations. <br /> DO NOT EXCAVATE IN ANY SZREET AND DO NOT TAP ANY MAIN without express approval of the <br /> Public Works Depa.rtment. 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 ha�ir natioe required. <br /> *************************************************************************** <br /> JOB SITE ADDRESS: ����� �$�i�✓�,S �'� /�'� ; <br /> Occupancy Type: Residential Commercial <br /> OWNER'S NAME: Phone No. : <br /> Mailing Address : City: <br /> .1 �/ � <br /> CONTRACTOR'S NAME: l.c.�`y-;l tif�K��, �«rz i" ,� C..��� �c"J Bus . Phone: `f %-� - c_ S � <br /> Mailing Address: �->( Cc�, ,��; �L'- City: �fx,�, � Zip: ��-�`�?i . <br /> *************************************************************************** <br /> PERMIT TYPE AND F$E CALCIILATION <br /> MIINICIPAL SEWER CONNECTION ( $30. 00 per stub) $ <br /> pipe size inches ; material PVC (on sand fill) ; cast iron <br /> SAC Charge ( $650.00 ) must accompany all sewer permii: applications unless <br /> prepaid. If not prepaid, a sewer connection permit will not be issued. <br /> MUNICIPAL WATER CONNECTION ( $30 . 00 per stub) $_ <br /> pipe size inches; material copper; other <br /> WATER METERS must be picked up and paid for at City Hal . <br /> ( 5/8" meters = $125 . 00 ; 3/4" meters = $163 . 00 ; 1" meters = $218 . 00 ) <br /> Water meters must be set and sealed by Orono Water Department (473-7357) <br /> upon completion of ineter installation. <br /> REQUIRED minimum setbacks from drainfield and septic tanks = 75 ' <br /> REQL'IRED setl�ack from sewer iine = 2G ` <br /> *************************************************************************** <br /> 1. Subtotal of above permit requested $_ <br /> 2. State Surcharge . 50 <br /> The State Building Code Division Surcharge of „50 per permit must be <br /> included for each well, sewer and water connecti��n permit requested. <br /> 3 . Postage & Handling (Only mail-in applications ) $ 1. 50 <br /> 4. TOTAL PERMIT FEE (add lines 1-3 above) $ <br /> ********************************************************************* <br /> The undersigned hereby applies to the City of Orono for issuance of a Utility Permit, <br /> agrees to do all work in strict accordance with the ordinances of the City and the <br /> regulations of the State of Minnesota,�and certif' s that al 1 statements made on this <br /> application are complete, true and oorrect. <br /> Signature of Applicant:�-��..��--, - Date: ��— 1-�- - %� <br />