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,� ��;'� <br /> �� <br /> CITY OF ORONO APPLICATION FOR UTILITY PERMITS f�_� <br /> , " ' Box 66 (2750 Kelley Parkway) SEWER/WATER ��r� � � <br /> Crystal Bay, MN 55323 � ;. <br /> ;� <br /> �" , ' ��� .� <br /> GENERAL INFORMATION � ,� j <br /> l. 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 /> 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. DO NOT EXCAVATE 1 �� <br /> IN ANY STREET AND DO NOT TAP ANY MAIN without express approval of the Public Works � .� <br /> Deparhnent. Issuance of a permit does not grant this approval. � <br /> �gY <br /> 7. All work must be done in accordance with State Code requirements. - y�� <br /> 8. All work must be inspected before it is covered. Ca11473-7357. ' , f �'`�� <br /> , ��� <br /> 24 hour notice required. ' � <br /> f��� I <br /> l� <br /> JOB SITE ADDRESS: �^`�D 4.��'�� A z�� �Z� .= a 4 �� <br /> OccupancyType: X Residential Commercial '`;r ���� <br /> Owner's Name: Phone Number: ���; <br /> ���: <br /> Mailing Address: City: 7�p; t � <br /> ''' Contractor's Name:��-���;rJ ���,r�.;3�.:c�- PhoneNumber: �3�3 -- �� ��-- � µ '�� <br /> �, <br /> �, �d ���, <br /> Mailing Address: c��� 1 l.9������.��� T Na�ity: N�L•-�-���v�7�p: �����5 �,c�� F``�: <br /> �� , � �; <br /> PERMIT T � ` � <br /> ,. <br /> � � � � <br /> .� � <br /> nici al 35.00 per stub) $ ' ~�<; <br /> ;-i <br /> pipe size inches; material Schedule 40 air tested; cast iron i; <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. � <br />�, . <br /> � �, <br /> Municipal Water Connection ($35.00 per stub) $ �' ' � <br />�.�; � ; <br /> pipe size inches; material copper; other `� <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' ; <br /> REQUIRED setback from sewer line=20' � _ , ' C ' � <br /> x� <br /> . , � .. s -s a.��. <br /> �.. <br /> PERMIT FEE CALCULATION �';','� ,�� �� <br /> 1. Subtotal of above permit requested ' ° `' $ °.� <br /> � 2. State Surchar�e $ .50 ';�� =x <br /> " �; <br /> � The State Building Code Division Surcharge of$.50 per permit must be t ' �; <br /> included for each weli, sewer and water connection permit requested. ��'" <br /> , .'�', `i <br /> � 3. Postage & Handling (Only mail-in applications) $ 1.50 <br /> 4. <br />`� 4. TOTAL PERMIT FEE (add lines 1-3 above) $ �' <br /> .m. <br /> ; ; <br /> �° The undersigned hereby applies to the City of Orono far 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 /> � _ � <br /> Minnesota, and certifies that all statements made on this application are complete,true and correct. ' � � �:: <br /> �� <br /> z � -��--- ;. � <br /> l Signature of Applican Date: �l- � <br />> <br /> � r, �;� <br /> i �� <br /> ., . . - <br /> • , ,:.�,h ,. _,- ; . . :��.. ,e,�< . r ,��. � � , � _ F_„�_ <br />