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: _-- _ _ _ _ . <br /> __ � <br /> CITY OF ORONO APPLICATION FOR IITILITY PERMITS <br /> - Box 66 (1335 So Brown Rd) SEWSR WATER �/3� <br /> Crystal Bay, MN 55323 <br /> ***********�**************************�************************************ <br /> I: You may�pp�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 /> Permit cards will be sent by return mail the same day the application is received. <br /> 3. Pe�its are not valid until you re�eive a penait card. <br /> 4. Work must not begin unless the permit card is available an the job site. <br /> 5. Utility connection permits may be issued to licensed contractors only. <br />. 6. Contact the Public Works Departm�nt (473-7357) for utility stub as-built locations. <br /> DO NOT F�CAVATE IN ANY STRg.'T AND DO NC7r TAP ANY MAIN without express approval of the `, <br /> Public Works Department. Issuance of a permit does not grant this approval. <br /> 7. All 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 �ti�e requised. <br /> *********************************************************************�***** <br /> JOB SITE ADDRESS: ��� /l,/O�'� � �`� <br /> Occupancy Type: Residential Commercial <br /> OWNER'S NAME: �� � ���5�� Phone No. : <br /> Mailing Address : City: <br /> CONTRACTOR'S NAME: Sv `Q`"7`� `��"` Bus. Phone: LI�o�" �" <br /> Mailing P�ddress: (�5� C �,�� , /� City: v�'to��� Zip: ��3 `/ <br /> *************************************************************************** <br /> ,�j�;u-p PERMIT TYPE AND FEE CALCIILATION <br /> MUNICIPAL SEWER CONNECTION (�$3�8�$fl 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 issuecl. <br /> ,3.s�da <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 ca�pletion of ineter installation. <br /> REQUIRED minimum setbacks f rom drainfield and septic tanks = 75' <br /> REQUIRED setback from sewer line = 20 ' <br /> *************************************************************************** <br /> l. Subtotal of above permit requested $ <br /> 2 . State Surcharge .50 <br /> The State Building Code Division Surcharge of .50 per permit must e <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 �lete, true and correct. <br /> Signature of Applicant: ` ���=�'� Date:�rF�� �l� <br />