Laserfiche WebLink
CITY OF ORONO APPLICATION FOR UTILITY PERMITS <br /> Box 66 (1335 So Brown Rd) SEWER WATER <br /> � �rystal Bay, MN 55323 <br /> *************************************************************************** <br /> I: You ma�pp�for utility pezm.its by mail or in person at the City offices. <br /> 2. Mailed in applications are subject to the postage and handling fees shown below. <br /> Pezmit cards will be sent by return mail the same day the application is received. <br /> 3. Pern�its are nat valid imtil ynu reoe.ivae a pe�it 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. <br /> DO NC7I' EXCAVATE IN ANY STREET AND DO NOT TAP ANY MAIN without express approval of the <br /> Public Works Depart�nt. Issuance of a permit does not grant this approval. <br /> 7. All work must be done in accordance wi.th State Code requirements. <br /> 8. Al1 work must be inspected before it is covered. Call 473-7357. <br /> 24 YxRar notioe rt�t�i red. <br /> **************************************�************************************ <br /> JOB SITE ADDRESS: -� � ,3'� c=/L .E'�-'. l � <br /> Occupancy Type: j' Residential Commercial <br /> OWNER'S NAME: S %�'� � �_� L� � T ��'--' � Phone No. : <br /> Mailing Address : � C- � � � �_' �� �`t,�. City: ������-��, �� � <br /> CONTRACTOR'S N�: ���"�'C ��. " /�+'?/ �-s���� � `i>.,' � �� <br /> Bus . Phone: �'" i T <br /> Mailing Address: ,�,� � ��"1/:r� i���«._ City: � .� � c. �' =k.�-Zip: s;,s'� <br /> *************************************************************************** <br /> ��,.�. PERMIT TYPE AND FEE CALCIII,ATION <br /> � MiTNICIPAL SEWER CONNECTION { $�6-6�6 per stub) $ <br /> pipe size �I inches; material��'�� y��PVC (on sand fill ) ; cast iron <br /> SAC Charge ( $700.00 ) must accompany all sewer permit applications unless <br /> prepaid. If not prepaid, a sewer connection permit will not be issued. <br /> MLTNICIPAL WATER CONNECTION ($30. 00 per stub) $ <br /> pipe size inches; material copper; other <br /> WATER 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 /> Water meters must be set and sealed by Orono Water Department (473-7357) <br /> upon co�pletion of ineter installation. <br /> REQUIRED minimum setbacks from drainfield and septic tanks = 75 ' <br /> REQUIRED setback from sewer line = 20 ' <br /> *************************************************************************** <br /> 1. Subtotal of above permit requested $ <br /> 2. State Surcharge .50 <br /> The State Building Code Division Surcharge of .50 per permit must e <br /> included for each well, sewer and water connection permit requested. <br /> 3 . Postage � Handling (Only mail-in applications) $ 1. 50 <br /> 4. TOTAI. PERIKIT FEE (add lines 1-3 above) $ <br /> *************************************************************************** <br /> The undersigned hereby applies to the City of Orono for issuance of a Utility Permit, <br /> agrees to do all work in strict accordance with the ordinances of the City and the <br /> regulations of the State of Minnesota, and certifies that all statements made on this <br /> application are co�lete, true co ect. <br /> Si nature of A licant: .� ,.--�-� � �� � � �/ �� S <br /> g pp _ Date: � <br /> `_- _ <br />