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• D�c-04-2001 12:44pr PrcR-CITY OF ORONO +G522404616 T-2C7 P.001/001 F-305 <br /> �a+}+u��eu iitavt� <br /> CITY OF ORONO A.PPLICATION FOR UTILITY PERMITS <br /> Box 66(2750 KcUey Parkway) SEVVER/WATER <br /> Crysfa!Bay,MN SS323 <br /> GEN L INFORMATION <br /> E, Ycu may appty for utiliry perrnits by rnail or u►person at the Ciry offices. <br /> 2, Mailed in applications ere subject to the postage and han3lin�fee showa below. Peirnit cards wilt be sentby <br /> return mail the same dny the application is rx�:ived. <br /> 3. Permits are oat valid until yoa reoeive a petmit eard. <br /> 4, Waic must not begin unless the permit card�s available oe the job site, <br /> 5. CJtility connxtian perruits may be issued to Licensed mntractors only. <br /> 6. Contact the Public Works Departmeat (95?-249�600} for uuliry stub as-buitt lxations. DO NOT <br /> EJCCAVA'I'E IN AIVY STREET AIv'D DO NC�T TAF ANY MAIN witho�t express approv�l of the Public <br /> Wo¢ics Deparhnenl. Issuance of a permit does not�ant this nppmval. <br /> 7. AII wark must be dont in eccerdence with Sta�e Code requirca►onts. <br /> �. AA wark must be inspeoted before it is covere+l, Cnll{952)�49-4b00. <br /> 24 hour noiice reqiirsd. <br /> .ro8 SIT'�A.DDR�s�:l �'�`� C'�,nc�,,;���',c�. �—����,�'"t. <br /> Qerupa�cy'I�'pe: � Residential Commercial <br /> Uwner's Nauit: C�- k..�n F-� t,��\c•c�c� Phose N�ber: <br /> Mailin�Address• City: Zi�x <br /> Contractor'a Namc:�1�-� - .�k�_� P6one Number:�i���- �i'_r3-'1`l 11 <br /> Mailing Addre,ss:����L1�s.k c��.�16,�'+�'.� . City:'C�l��.o� T�P���S <br /> P��7 TYPF�`���a��C�—� <br /> Municipal Sewer�($35.OQ per stub) $ � <br /> V���� pipe siae inches; matenal, Schedule 44 eir tested; cast iron <br /> ""�` SAC Chuge (200Q rate$1,150.40)must acconipa.ay all stwer ptamit applicatians unless prepaid <br /> �+ � If uot preptud,a sewer connection permit will�wt bc issued. <br /> �:����;c��� t <br /> Municipal'1�ater C-�ehea{$35.00 per stub) $ <br /> pipc siu inahes; material copper; other <br /> WATER METERS must be picic�ed up and pai�i for at City Hall. - <br /> Water meters mast be set and seaied by (Ironu Water Depat�m�nt {952-?A9-4600) npon <br /> completion of cuet�r itust�llxtivn. ' <br /> REQL�.ED aunimum setbacks fram drain�ield and septic tanks=75' <br /> REQUIRE.T7 setback$om sewer line=20' <br /> PEBMT�'�'FE�ai.c[rLATTON <br /> 1. Subtotal of abavc gcrn�it rGqucstcd $ <br /> 2. Stata Sutc�c ' $ .50 <br /> The Stato Building Code Division Surcha�gc o�'$.SU per permit must be . <br /> ineiuded for a►tsh well,sewer and water conne�tion peraiit requestccL <br /> 3. postage&�Tandling(Only mail-in applications) _ � 1.50 <br /> 4. T�TA.L PERIvL�T FEE(�dd lincs 1-? above) � <br /> The undersigned hereby applies to the City of t?rono for issuance of a Utili�; Dermit, agrccs to do <br /> all work in striet �Ccord�te with thc or�ir:a^�es of the Cifiy and tbe regulations of thc State of <br /> Minncsota,and certifies that all statements made on this aQplication are complete,truc and correct. <br /> Signat�uure of Applicari� Date: <br />