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F '"ti <br />�a J CITY OF ORONO APPLICATION FOR UTILITY PERMITS y k <br /> � ; <br /> �ox 66 (2750 Kelley Parkway) SEWER/WATER ��� <br /> Crystal Bay, MN 55323 { <br /> �.{ � , _ J�� -� <br /> GENET2AL INFORMATION � � � � � <br /> � � � ;� <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. Permit cards will be sent by <br /> return mail the same day the application is received. � <br /> 3. Permits are not valid until you receive a permit card. ; �, ; <br /> ��.r�:� <br /> 4. Work must not begin unless the permit card is available on the job site. a <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. DO NOT EXCAVAT`E �:�- '' <br /> IN ANY STREET AND DO NOT TAP ANY MAIN without express approval of the Public Works �' <br /> Department. Issuance of a permit does not grant this approval. ' '"` <br /> 7. All work must be done in accordance with State Code requirements. � �r' <br /> 8. All work must be inspected before it is covered. Call 473-7357. : � �� <br /> 24 hour notice required. <br /> �-_ ;r - <br /> � — <br /> s <br /> JOB SITE ADDRESS: �� _�S �L. �---����� � ;�=���'\`�tc� <br /> Occupancy Type: Residential Commercial <br /> .r, <br /> Owner's Name:���- �v1���/ �� �-> PhoneNumber: `-{��) �- � �- l l� .� ;�` <br /> Mailing Address: City: 7�: <br /> Contractor's Name: (.�-���� ! � �``��--� Phone Number: �I �� i � 1.,,'� <br /> MailingAddress: ��`��1 � 1'1�wt �`��r- City: � ) 1.=-�1�.�.� Zip: :�,_ � .:� �, � <br /> 1 ' <br />.. �.—5..:� <br /> y;. <br /> F1�' <br /> PERMIT TYPE � . �.�.: <br /> Municipal Sewer Connection ($35.00 per stub) $ <br /> pipe size L� `� inches; material G''Schedule 40 air tested; cast iron <br /> SAC Charge($950.00)must accompany all sewer permit applications unless prepaid. If not prepaid, <br /> . a sewer connection permit will not be issued. F `,, <br /> �� <br /> Municipal Water Connection ($35.00 per stub) $ <br /> pipe size inches; material copper; other '��i <br /> WATER METERS must be picked up and paid for at City Hall. � � ;� <br /> (5/8" meters= $139.00; 3/4" meters =$191.00; 1" meters = $247.00) � <br /> Separate Plumbing Permit issued for water meter. ��� �� <br /> . Water meters must be set and sealed by Orono Water Department(473-7357)upon completion '°; ,�� <br /> of ineter installation. '� <br /> REQUIRED minimum setbacks from drainfield and septic tanks= 75' c � <br /> REQUIRED setback from sewer line=20' �� �� <br /> PERMIT FEE CALCULATION �. <br /> t ; <br /> 1. Subtotal of above permit requested $ <br /> 2. State Surchar�e $ .50 ` L `.' <br /> The State Building Code Division Surcharge of$.50 per permit must be � �r <br /> included for each well,sewer and water connection permit requested. <br /> 3. Postage & Handling (Only mail-in applications) $ 1.50 � <br /> �; <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 Permit, agrees to do � <br /> all work in strict accordance with the ordinances of the City and the regulations of the State of s �; <br /> Minnesota, and certifies that a�l statements made on this application are complete, true and correct. "�' <br /> r ;� <br /> ,, <br /> � �� �f� r <br /> Signature of Applican� � Date: � � <br /> ,�;. <br /> _ , � �� <br /> �. <br /> � � , , . .��..., <br /> _ � �r . . .. � -. _.r .��,. -_ _ ,.. .. <br />