Laserfiche WebLink
Cl'1'Y OF ORONO APYLICATION T�3l12 UTILITY PERMI'I'S ��,5�'���r <br /> I3ox GG (2750 Kelley Parkway) S�WER/WAT�R <br /> �,_____--- - <br /> Crystal 13ay, MN 55323 <br /> ccrrraA� iNro�imnT�orr <br /> l. 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 tlie 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 perniits 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 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 hour notice required. <br /> JOBSIT�ADDI2�SS: <br /> Occupancy Type: � Resi ia Cominercial � <br /> Owner's N�me: Phone Number: - �5- <br /> Mailing Address: City; 7�p• <br /> Contractor's Name: .� PhoneNu er: yy� iy� <br /> Mailing Address: City: �' 71p' S��'��5— <br /> P�IZMIT TYPE <br /> Municipal Sewer Con ection ($35.00 per stub) $ <br /> pipe size��nches; material_��'VC (on sand fill); cast iron <br /> SAC Charge($850.00)must accompany all sewer permit applications unless prepaid. If not prepaid, <br /> a sewer connection permit will not be issued. <br /> Munici�al Water Connection ($35.00 per stub) $ <br /> pipe size inches; material copper; other <br /> WATER MF,"1'LRS must be picked up and paid for at City Hall. <br /> (5/8" meters = $139.00; 3/4" meters = $191.00; 1" meters = $247.00) <br /> Separate Plumbing Permit issued for water meter. <br /> Watcr mctcrs must be set and sealed Uy Orono Watcr Department(473-7357) upon completion <br /> of ineter install;�tion. <br /> REQUIRED minimum setbacks from drainfield and septic tanlcs = 75' <br /> REQUIRED setback from sewer line = 20' <br /> P1�;RMIT rI;C CALCULATION <br /> 1. Subtotal of above perinit requested $ <br /> 2. State Surchar�e $ .50 <br /> The State [3uilding Code Division Surcharge of$.50 per permit must be <br /> included for eadi well, sewer and water connection permit requested. <br /> 3. Postage & IIandline (Only mail-in applications) $ 1.50 <br /> 4. TOTAL I'ERMI'r FEE (add lines 1-3 above) $ <br /> The undersigned hereby applies to the City of Orono for issuance of a Utility Permit, agrees to do <br /> all work in strict accordance with the ordinances of the City and the regul�tions of the State of <br /> Minnesota, and certifies that all statements made on this application are complete, true and correct. <br /> Signature of Ap��licant:_,�=���������, Date:����� _��' <br /> ----�"� <br />