Laserfiche WebLink
Metadata
Document management portal powered by Laserfiche WebLink 9 © 1998-2015 Laserfiche. All rights reserved.
FROM : PHONE N0. : 612 477 6208 Oct. 02 2001 a8:27AM P2 <br /> r, . ,.. �o .._.. „ , <br /> CITY UF ORONO .� .. . `,.',A�.'PLTC�t�`rZ�l'�1:,�4A;UTXI.YTY PERMITS <br /> Box-66 (27.50 KelXey Patkway) . . : . �'SEWE��/�VATER <br /> Crysta7 Bay, MN 5�323.� <br /> G�1vFRAL YNFQ�M�. <br /> �, You may apply for utility permits by mail or in person at the City offices. <br /> 2, Maiied in applications are subject ta the postaga and hac�dling fee shown below. Permit cards will be sent by <br /> retum mail the same day the application is received, <br /> . 3, Percciits are not valid unt31 you rece[ve a petmit card. � � <br /> � 4:. Work must noc begin unless the permit card fs available on the job site. <br /> 5. Utiliry connection permlts r�ay be issued to licensed contractors only. <br /> 6. Contact the Public Worlcs Departmeat �952-249-4600) for utility swb as-built locations. b0 NOT <br /> EXCAVATE TN ANY S'I'REET A1�D DO NOT TAP ANY MAiN without e�cpress approval of t�e Public <br /> Works Deparmnent. Issuance of a permit does not grant this approval. . <br /> 7. All work must be done in accord�nnce with State Code requirements. �j� <br /> g, plt work must ba inspected before it is covared, �Call(95Z)249-4600. � � <br /> � 24 hour notice required. � `' ` <br /> �1. �<,. <br /> ;, <br /> rOB SITE ADDRESS: 37 3 3 L 1� c9i��� <br /> � ��r�r'1'" J. <br /> Occupancy Type: Re�idet�tial�� Commerciai <br /> Owner's 1Vame• L�sf GS Phone�Tumber:�~l�O�� .`>�.3'��a� <br /> � <br /> Mailing Address: 33 � City; !�I'1 15 7�; 5��L �� <br /> Cantractor's�1�me: � E Phone um �03 ' � <br /> 1VYailiugAddress: d0 _ City: `Zi�:� 73 <br /> PF.R �:T TYP.� 6„ _--p-r� <br /> Municipal Se�ver C nnectiou ($35.00 per stub) � , $ _ '�J f - <br /> pipe size�.inches; �. material �chedule 40 air tested; cast iron <br /> SAC Charge (2000 tate $1,150A0) must accorr�pany all s�w�permit app�ications unless prepaid. <br /> If not prepaid, a sewer connection pezmit will not be issued. <br /> Muaic�pal Water Connection ($35.00 per stub) $ -s, O � <br /> pip� si2e_�in�ches; material v�'opper; othex . <br /> WATER,METLRS must be picked up and paid for at City Hail. <br /> Water meters mnst be set and sealed by Oxono Water Department (952-249-4600} upon <br /> com�letion af aieter installstion. <br /> REQUIRED minimum s�tbacks from drain field and septia tanks=75' <br /> REQUIRED setback from sewer line=ZO' <br /> � � PERMI�CAX.•CULAT`ION . � . � 4 <br /> 1. Subtotal of above permit requested � $�r D <br /> 2, St te Surch � <br /> The State Build�ng Code Division Surchargg aP�$.SO per permit raust be <br /> . in�ludod for each weil,sewer and water eonnection permit requested. <br /> 3. �,istage & Ha.n�.li��(Only mail-i�applicaC'sons) $ <br /> 4. . TOTAI; PERMIT FEE�ac�d lines 1-3 above) $ �� 'J� <br /> 'rhe undersigncd 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 <br /> Minnesota,and certifies that all statements made on this�application are complete,true aa.d correct. <br /> � � � 2 �l <br /> Signature of Applica : Date: <br />