Laserfiche WebLink
� ' D�c-04-20C1 12:44pn Frort-CITY OF ORONO +pg224D4616 T-2C7 P.001/001 F-305 <br /> (�J�lNi1lR1(r/1L+/Vlf <br /> CITY OF ORONO A.PPLICATION FOR UTILITY PERNIITS <br /> Ba�66(2750 KcUey Parkway) SEVVEIt/WATER <br /> Crysta!Bay,MN 55323 �C� �(�7W <br /> GENE L INFORMATION / <br /> F. You mey apgty for utility parmits by mail or'v�person at the City off►ces. <br /> 2. Mailed in applicntions are subject to the postage awd handlin�fee st�owa below. Permit eards will be sentby <br /> retum mai!the same day the applicatian is recaived. <br /> 3, Permits are not valid until yoa reoeive a petmit eard. <br /> 4, 'Wak must not begin unless the permit card ia avnilable on the job site. <br /> 5. Utiliiy connxtion permits may be issued w licens�d cantractors only. <br /> 6, Contact the Pubiic Works Department (95�-249�600} for ut�ity stub aa-built lncations. DQ NOT <br /> IXCAt'AT'E IN AlVY STREE'T A?v'D DO NOT TAP ANY MAIN witho�t express approval of the Public <br /> Warks Ik�artmen� Issuance of a permit does not pant this approval. <br /> 7. All wark utust be done in accerdenae rrith Sta e Code ro�uireinapts. <br /> , 8. AA wcsk must be iaspocted before it is coveral. Gdl(952)Z49-4600. <br /> 24 hour aotice req�ired. <br /> JOB SIT�ADDR�$S: ���=� �7 C�G(� �^�;C� E �� c�;�t_��. <br /> Occupaacy'I��pe: �C Rcsidential Commerciat <br /> Owaer's Nstme: �` � � ���a � •d�'-nc� Phoae Namber: <br /> Mailia�Addr�s9� City: Zi�x <br /> Contrsctor'a Na.u�e: 1� ^, � P6out Nt�be�-�-l�.i - �' `��� <br /> Mailing Addresa:f 5 �1 j���rd-, 1�?.-�� City:�YLtk�,, T�i: �53c� <br /> PER�'�'1YT TYPTL ��,,c_.c����i� <br /> r.i� Municipal Sewer C-o�ee�ian ($3 5.00 por stu b} $ <br /> pipe size__inch�es; material Schedule 44 esr tested; cast iron <br /> �' Sh��ha:.*ge��f19G raie$1,150.00)must acconipany all stwtr pta�nit applications unless prepaid. <br /> �� S If nat prep�.d,a sewer connec:�i�n permit will�wt be issued. <br /> ►�1`�-G�1'C�C_ <br /> Ntunicipal'�stter�n($�.00 per stub) $ <br /> pipc aiz,c inches; material copper; other <br /> WAT'ER METERS must bc gicked up and pai�l for at City Ha11. <br /> Water metere mast be aet aad sealed by Clrono Water Depar�►ent (952-?A9-�t600) upon <br /> . completian of inetGr instullution. ' ' <br /> REQL�U minimum setbacks fram drain field and septic tanks=75' <br /> REQU'IRED setback$om sewer line =2Q' <br /> PFBMIT��,E.CALCLT��ATIQN • <br /> i. , Subtoiai oi abovc pcmiit rCqucsicd $ <br /> 2. Stata.Surc}�attze ' $ .50 <br /> 'Ihc Stato Building Codo Divisioa 5archugc o�'S.SO per permit must be <br /> includad for eacYi walI,sewer and water conne�tion permit requrstect. <br /> 3. 'Postage&�andling(Orily mail-in applications) � 1.50 <br /> 4. TOTAL PERMIT FEE(add linos 1-3 abave) $ <br /> The undersigned hereby applies to thc City of th�ono for issuan�t of a Utility Permi�agrces to do <br /> all werlc in st�ei accordantt with thc ordinanxs of the City and tbe regulations of the State of <br /> Minncsota�and certifies that all statcmeuts made on this application are complete,true and correct. <br /> Signature o2 Apptican� Date: <br />