Laserfiche WebLink
Document management portal powered by Laserfiche WebLink 9 © 1998-2015 Laserfiche. All rights reserved.
� <br />� ` <br /> (Updated 1/5/04) <br /> CITY OF ORONO APPLICATION FOR UTILITY PERMITS <br /> Boz 66(2750 Kelley Pazkway) SEWER/WATER& SAC <br /> Crystal Bay,MN 55323 <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 We postage and handling fee shown below. Permit cards will be sent by retum mail We same day <br /> the application is received. <br /> 3. Permits are not vatid 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 conhactors only. <br /> 6. Contact the Public Works Department(952-249-4600)for utility stub as-built locations. DO NOT EXCAVATE IN ANY STREET AND <br /> DO NOT TAP ANY MAIN without express approval of the Public Works Department. Issuance of a pernut dces 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(952)249-4600,24 hour notice required. <br /> JOB SITE ADDRESS• 4132 highwood road <br /> Occupancy Type: � Residential Commercial <br /> Owner's Name: Scott Anderson Phone Number: (952)472-6089 <br /> Mailing Address:4132 Highwood Road City: Orono Zip: 55323 <br /> Contractor's Name: Roto-Rooter Phone Number: (763)5449551 <br /> Mailing Address:74530 27th ave N City:PLYMOUTH Zip:MN <br /> PERMIT TYPE ❑Connections �Repairs ❑Disconnect (Check One) <br /> SAC Charge (2003 rate$1,350.00) $ (Set Rate) <br /> Sac Charge must accompany all sewer permit applications unless prepaid. <br />� (If not prepaid,a sewer connection will not be issued) <br /> Municipal Sewer Connection/Disconnect/Repair($35.00 per stub) $ ;35.00 <br /> pipe size 4 inches; material PVC Schd 40 air tested; cast iron <br /> Municipal Water Connection/Disconnect/Repair($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 /> Water meters must be set and sealed by Orono Water Department <br /> (952-249-4600)upon completion of ineter installallon. <br /> REQUIRED minimum setbacks from drain field and septic tanks=75' <br /> REQUIRED setback from sewer line=20' <br /> PERMIT FEE CALCULATION <br /> 1. Subtotal of above pernut requested $535.00 <br /> 2. State Surchar�e $ .50 (Minimum) <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&Handling(Only mail-in applications) $ 1.50 (Mail In Only) <br /> 4. TOTAL PERMIT FEE(add lines 1-3 above) $ 535.50 <br /> The undersigned hereby applies to e City of Orono for issuance of a Utility Permit, agrees to do all work in strict <br /> accordance with the ordinances o City and the regulations of the State of Minnesota,and certifies that all statements <br /> made on this application are co ete, and correct. <br /> Signature of Applicant: �`'� Date: /D'�G�—�`� <br /> R Form <br />