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FROM : PHONE N0. : 612 477 6208 Aug. 28 2001 08:33AM P5
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<br /> GENEfiAY,Il�i�'ORIV�ATT9N . . . � , . .
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<br /> 1: You may apply for uhlity.perm�ts by mail or in person at xhe:Ciry'o€fces. ; . . � � �
<br /> 2.. Mailed ua applications.Are:subject co tlie postage and:handling fee sliovvn below.:Permircards will be.sent by � � . �
<br /> � retuzn mail the saine day.the Application is received. �-� � ' .\�.
<br /> 3. : ' . Permits are not vslid until you receive a permit:card. , � ' �� �
<br /> .:,,4. : � . VVork musi,not begin unless the permit,car.d is available on the job site, � .�
<br /> � 5: Utiliry cotu�ection permits may be issued to,licensed contractors onl�. � .
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<br /> 6. Contact the Public Works Department (952-249-4600) for.utiliry stub as-built locauons. DO NO�' `
<br /> . �XCAVATE IN ANX STREET AND DO NOT'�AP iANY Iv1AIN without express approvaI of the Public
<br /> ` Works Deparcmeni. Issua�nce of a permit does.not grant this approval.�
<br /> • 7. All.work must be done.in accordance with Stafe Code rCquirements.
<br /> . 8. All wo��must be inspected before it is covered. Ca11(952).249=4600. � �
<br /> � 24 hour notiee required.
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<br /> JOE SY'X'E,AADRESS: �7 �-� �r .�;r� 7�-i
<br /> Occupaacy Type: r� Resideutial C�mamercia�
<br /> . Owner's Name: .�'e. . � �•� Pl�one N b�7lv 3 .SrS 3-a�'a`;�
<br /> Mailing Address: 'l � 3� Cityr� /5 7.i�: �Js `f 7�
<br /> Contxactor's Name: � 9`�: Phone be . �� 77� �a'�' , .
<br /> . ' M�ailing Address: City: �,.i� �1�: , .5�7�
<br /> PERMYT'TYPE � � . .
<br /> Muriicipa� Sewer Connection ($35.00 per stub) $ ��'
<br /> pipe si2e�inches; m�tcrial �' Schedule 40 ai�r tested; cast ixon
<br /> SAC Ck�arge (2000 rate $1,.150.00)must accor�pany a11 sewer perrnit applications unless prepaid.
<br /> � I�'not prepaid, a s.ewer connection permit will not be issued.
<br /> � . Mnnicipa�Water Connectio�u ($35.00 per stub) $ � � �
<br /> �ipe size�" inches; mat�rial v .co�per; otl�er
<br /> � ' W1�;TER METERS must l�e picked up and pa�d far at City Hall.
<br /> VVater meters must be set and sealed by Orona. Water bepartment.(952-249-4600) upon
<br /> completron o�meter insta��ation.
<br /> ,REQUIRED nainimum setbacks�rorn drain field and septic tanks=75`
<br /> REQUIRED setback from sewer.line=20' �
<br /> P�RMIS b otal of abo e��ATION' �./ �)
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<br /> permlt xequest � . /�• a v
<br /> 2. State Surchar e $ •50
<br /> � Tbe State.Building Code Division Sur.charge of$.50 per permit nnust be
<br /> included for each well,sewer and water connection permit requested. � . �
<br /> 3;.� Posta�e & Handlxn�(Only mail-in applications) $ `�+��.. . . � .
<br /> - . �, . 4:: :- TOxAL PERMIT:FEE(add lines 1-3 above) $ - ;?4 � �� ; .
<br /> The undersigned hereby applies to the,City of Orono�or issuance of a UtiYity Permit, agrees to do
<br /> all work in strict accordance with the ordinances of the City and the regulations of the State.o�
<br /> Minnesota,and cextifies that all statements zt�ade on this application aze complete,true and cortect.
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<br /> Signature a�Applicant: G�°i'�GC!�: ��-i . Date: �'���� /
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