Laserfiche WebLink
CITY OF ORONO APPLICATION FOR UTILITY PERMITS <br /> Box 66 (1335 So Brown Rd) SEWER WATER WELL ; �.N <br /> ******1*B******************************************************�***�*�**��� � `� ✓ ( <br /> Genes�al Instructions <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. <br /> Permit cards will be sent by return mail the same day the application is received. <br /> 3. Permits are not valid nntil yon 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. <br /> DO NOT EXCAVATE IN ANY STREET AND DO NOT TAP ANY MAIN without express approval of the <br /> Public 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 473-7357. � � � <br /> 24 honr notice reqaired. �� <br /> ***,�*******************,t*,t*****************,t*,t**,t,t******,t***********�,�'**,t�** � <br /> JOB SITE ADDRESS: �.�,5 �?� � /'`--�-�,1.-�� 4--'v�_ �, <br /> Occupancy Type: Residential.� Commercial <br /> .�. <br /> owrr�x�s N�,rsE: ?u�;L _ l�.�� [�� ��k.��.,.�, P h o n e N o. . (� % -- 3 3.�_3 <br /> Mailing Addres� City: <br />�CONTRACTOR'S NAME: �� ���� „�,� •, f�'lC5 Bus. Phone: ��3�`�73 �_3 <br /> Mailing Address: ;`. ,�� `" C�-.-� ,�-� City: � � „�; Zip: ',��.�y� <br /> ******************************************************** ****************** <br /> PERMIT TYPE AND FEE CALCULATION <br /> MIINICIPAL SEWER CONNECTION ($30.00 er stub) $ <br /> �i�e size �inches; material �PVC (on sand fill) ; cast iron <br /> SAC Charge ($575.00 ) must accompany all sewer �ermit applications unless <br /> Frepaid. If not prepaid, a sewer connection permit will not be issued. <br /> MIINICIPAL W TER CONNECTION ($30.00 �er stub) $ <br /> �i�e size �inches; material /C copper; other <br /> WATER METERS must be picked up and paid for at City Hall. <br /> (5/8" meters = $111.30; 3/4" meters = $146.28 ) <br /> Water meters must be set and sealed by Orono Water Department (473-7357) <br /> upon completion of ineter installation. <br /> PRIVATE WELL INSTALLATIONS ($30.00 per job) $ <br /> Check: New Replacement Repair <br /> Casing size: inches <br /> REQUIRED minimum setbacks from drainfield and septic tanks = 75' <br /> REQUIRED setback from sewer line = 20 ' <br /> CAI,L FOR A SITE LOCATION BEFORE DRILI,ING <br /> Upon completion, City must be sent a copy of State Well Record. <br /> *************************************************************************** <br /> 1. Subtotal of above permit requested $ <br /> 2. State Surcharge .50 <br /> The State Building Code Division Surcharge of .50 per �ermit must be <br /> included for each well, sewer and water connection permit requested. <br /> 3. Postage & Handling (Only mail-in applications) $ 1.50 <br /> 4. TOTAL PERMIT F$E (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 complete, true and correct. <br /> ( <br /> SignaturE of A�plicant��'"� �L�,.`, i_ �,_ �,.,...� Date: _S �_ t, , _��, <br /> �� <br />