Laserfiche WebLink
. <br /> � _:;T�: OF ORONO APPLICATION FOR UTILITY PERMITS ��j <br /> - ,Box 66 (2750 Kelley Parkway) SEWER/WATER ��'�j� ' <br /> . Crystal Bay, MN 5�323 � <br /> GE1vERAL 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 handlin�fees shown below. Permit cards will be sent <br /> by 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 /> �. Utility connection permits may be issued to licensed contractors only. <br /> 6. Contact the Public Works Department(249-4600)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. Ca11249-4600. <br /> 24 hour notice required. <br /> JOB SITE ADDRESS: ��� ���s� ��,r ����' �u-��f` <br /> Occupancy Type: �- Residential Commercial <br /> Owner's Name: �o,:S S��2..��--�/ Phone Number: <br /> Mailing Address: %3o f—�,�i �/�.r�� �.A�� City: (`,i�yv 7ap: <br /> Contractor's Name: Gc.J�c%rye� ��✓� Phone Number: ��- S/�- /sijs"� <br /> l��ailing Address: �v �o.x. �/S City:Si'"�-�1 Zqr. S-��y� <br /> PERMIT TYPE <br /> �Iunicipal Sewer Connection ($35.00 per stub) $ <br /> pipe size�inches; material�chedule 40 air tested; cast iron <br /> SAC Charge (2000 rate $1,100.00) must accompany all sewer permit applications unless prepaid. <br /> If not prepaid, a sewer connection permit will not be issued. <br /> 1�Iunicipal`Vater Connection ($35.00 per stub) $ <br /> pipe size inches; material copper; other <br /> WATER METERS must be picked up and paid for at City Hall. <br /> `Vater meters must be set and sealed by Orono Water Department(249-4600)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 /> l. Subtotal of above permit requested $ , ` � � r�`> <br /> ...� _� <br /> 2. State Surchar�e $ .50 <br /> The State Buildin�Code Division Surchar�e of$.50 per permit must be <br /> included for each well,sewer and water connection permit requested. ;\ <br /> 3. Postage & Handlina (Only mail-in applications) $ . 0 �'� <br /> 4. TOTAL PERMIT FEE (add lines 1-3 above) $ ' 2� � � <br /> The undersigned hereby applies to the City of Orono for issuance of a Utility Permi�; agrees to do <br /> all �vork in strict accordance with the ordinances of the City and the regulations of the State of <br /> �linnesota, and certifies that all statements made on this application are complete,true and correct. <br /> Signature of Applicant��a�n� /��4��� Date: //��� <br />