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 /> . <br /> Box 66 (2750 Kelley Parkway) SEWER/WATER ,�� <br /> Crystal Bay, MN 55323 %�0 �� -� <br /> � <br /> GENERAL INFORMATION <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. Permit cards will be sent by <br /> return mail the 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 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 /> Deparhnent. 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 /> JOB SITE ADDRESS: �4�5 �l,�t�'���y 1`t�t'� <br /> Occupancy Type: }L Residential Commercial <br /> Owner's Name: (�;en t (,t9Cc�-�'v� Phone Number: �/�j'y y� <br /> Mailing Address: Z- �'' u r� �P v-� ity: �%�'h�' 7ip: �' 3 c/ <br /> Contractor's Name: q� ( L�; -�r Phone Number: 7 —p/z z 7z 3--�`� <br /> Mailing Address: `�/�3 �o�t K r �,�'� City: ,'��n< <r;'� 7�: �5 3� <br /> PERMIT TYPE <br /> Municipal Sewer Connection ($35.00 per stub) $ <br /> pipe size inches; material Schedule 40 air tested; cast iron <br /> SAC Charge ($1,000.00) 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 /> WATER METERS must be picked up and paid far 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 /> Water meters must be set and sealed by Orono Water Department(473-735�upon completion <br /> of ineter installation. <br /> REQUIRED minimum setbacks from drainfield and septic tanks = 75' <br /> REQUIRED setback from sewer line=20' <br /> PERMIT FEE CALCULATION <br /> 1. 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 Utility Permit, agrees to do <br /> all work in strict accordance with the ordinances of the City and the regulations of the State of <br /> Minnesota, and certifies that all statements made on this application are complete, true and correct. <br /> � � =�//�-- <br /> Signature of Arrlicant•„�„� t Date: <br />