Laserfiche WebLink
s <br /> � , CITY OF ORONO APPLICATION FOR UTILITY PERivIITS �'�z�C <br /> Box 66 (2750 Kelley Parkway) SEWER/WATER <br /> Crystal Bay, MN 5�323 <br /> GENERAL INFOR�'�IATION <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. Pemut cards will be sent <br /> by return mail the same day the application is :eceived. <br /> 3. Permits are not valid until you receive a per��it c�rd. <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 pernut 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 /> JOB STTE ADDRESS: � .� � �-���" ��� <br /> Occupancy Type: Residential Commercial <br /> Owner's Na.�ne: � PhoneNumber: <br /> Mailing Address: - � .�-- ,�-� City: 7ip: <br /> Contractor's Name: PhoneNumber: �y�J /��S`- <br /> Mailing Address: ` City: 7ap: ,S"�'��� ^ <br /> PERMIT TYPE <br /> Municipal Sewer Connection ($35.00 per stub) $ <br /> pipe size �1 _ inches; material+'`R/� PVC (on sand fill); cast iron <br /> SAC Charge ($750.00) 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 /> �4VATER METERS must be picked up and paid for at City Hall. <br /> (5/8" meters = $133.00; 3/4" meters = $181.00; 1" meters = $235.00) <br /> Separate Plumbing Permit issued for water meter. <br /> Water meters must be set and sealed by Orono Water Department (473-735'� upon <br /> completion of ineter installation. <br /> REQUIRED minimum setbacks from drainfield and septic tanks = 75' <br /> REQLTIRED setback from sewer line = 20' <br /> PERMIT FEE CALCULATION <br /> l. 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 Utiliry 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 /> conect. <br /> Signature of Applicant:_������2�j��-�� �: /� - /�_ _� <br />