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!� � <br /> CITY OF ORONO APPLICATION FOR UTILITY PERMITS <br /> Box 66 (2750 Kelley Parkway) SEWER/WATER <br /> Crystal Bay,MN 55323 <br /> :.�,. <br /> GENERAL INFORMATION <br /> 1. You may apply for ufility permits by maii or in person at the City offices. •' � � <br /> 2. Mailed in applications aze subject to the postage and handling fee shown below. Permit�ards wil�.be sen�y'V <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 (952-249-4600) for utility stub as-built locations. DO NOT <br /> EXCAVATE IN ANY STREET AND DO NOT TAP ANY MAIN without express approval of the Public <br /> Works 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(952)249-4600. <br /> 24 ho r notice required. <br /> (��vy� <br /> JOB SITE ADDRESS: � � <br /> Occupancy Type: Reside Commercial <br /> Owner's Name: Phone Number.�5'�-yv73�� <br /> Mailing Address: City• <br /> Contractor's Name: Phone Number: ` �- <br /> Mailing Address: City: � T� � <br /> PERNIIT TYPE <br /> Municipal Sewer C' pnnection ($35.00 per stub) $ ���� <br /> pipe size Y inches; material Schedule 40 air tested; cast iron <br /> SAC Chazge(2000 rate$1,150.00)must accompany all sewer permit applications unless prepaid. <br /> If not prepaid,a sewer connection permit will not be issued. <br /> � <br /> Municipal Water Connection ($35.00 per stu $ �� <br /> pipe size�inches; material copper; other <br /> WATER METERS must be picked up and pai for at City Hall. <br /> Water meters must be set and sealed by Orono Water Department (952-249-4600) upon <br /> completion of ineter installation. <br /> REQUIRED minimum setbacks from drain field and septic tanks=75' <br /> REQUIRED setback from sewer line=20' , <br /> PERNIIT FEE CALCULATION <br /> 1. Subtotal of above permit requested $ ��•� <br /> 2. State Surchaz�2e $ .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 Pernut, 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 stateme ade on this application are complete,true and correct. <br /> Signature of Applicant: Date: �� �� «� <br />