Laserfiche WebLink
Metadata
Document management portal powered by Laserfiche WebLink 9 © 1998-2015 Laserfiche. All rights reserved.
CITY OF ORONO APPLICATION FOR DTILITY PERMITS „ <br /> Box 66 (1335 So Brown Rd) t 1 SEWER WATER <br /> Crystal Bay, MN 55323 <br /> ***********�*************�************************************************* `_ <br /> I. You may�pply�or 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 /> Perm.i.t cards will be sent by return mlil the same day the application is received. <br /> 3. Pea�i.ts are m�t valid Until y�u reoeive a peimi.t card. <br /> 4. Work must not begin unless the permit card is availa.ble an the job site. <br /> 5. Utility connection permits may be issued to licensed contractors only. <br /> 6. Contact the Public Works Departme.nt (473-7357) for utility stub as-built locations. <br /> DO NOT EXCAVATE IN ANY STREE'r AND DO NOT TAP ANY MAIN without �ress approval of the <br /> Public Works Depaztment. Issuanoe of a permit does not grant this approval. <br /> 7. Al1 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 haur mtioe required. <br /> ************************************* ********************�**************** <br /> n <br /> JOB SITE ADDRESS: , C�� � ' "'- ' <br /> Occupancy Type: Residen al Commercial <br /> OWNER'S NAME: /�/ � � � Phone No. : �?� -���� ` <br /> Mailing Address: •, -- City: � �� ` <br /> CONTRACTOR'S NAME: Bus . Phone: ������ <br /> Mailing Address: � � ,' � � City: �: Zip: _�,`- � <br /> *************************** ***************************** ************** <br /> - _,_. <br /> PERMIT TYPE AND F$E CALCIILATION <br /> MIINICIPAL SEWER CONNECTION ($30. 0� per stub) $ <br /> pipe size � _inches; material. .��: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 /> MIINICIPAL 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 completion of ineter installation. <br /> REQUIRED minimum setbacks from drainfield and septic tanks = 75' <br /> REQUIRED setback f rom 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 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 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 and correct. <br /> i <br /> Signature of Applicant��; g �0_ " Date: �/��"�j� .-- <br /> : ; , <br /> �. , � • <br />