Laserfiche WebLink
(Updated 5/3/02) <br /> CITY OF ORONO APPLICATION FOR UTILITY PERMITS <br /> Box 66 (2750 Kelley Parkway) SEWER/WATER& SAC <br /> Crystal Bay,MN 55323 <br /> r <br /> GENERAL INFORMATION <br /> 1. 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 fee shown below. Permit cards will be sent by return mail the same day <br /> 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(952-249-4600)for utility stub as-built locations. DO NOT EXCAVATE IN ANY STREET AND <br /> DO NOT TAP ANY MAIN without express approval of the 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(9552)249-46000,24 hour notice required. <br /> JOB SITE ADDRESS: `� 7S3 <br /> Occupancy Type: Residential Commercial <br /> Owner's Name: Phone Number: -_3,59-- y y 1!�' <br /> Mailing Address: City: Zip: <br /> Contractor's Name:_ Phone Number: 9S�a- ?- tS�l1� <br /> Mailing Address: 7t -s k*Z fT_ OLS- City: mT� Zip: 3-,5_39'62 <br /> PERMIT TYPE ❑Connections ❑Repairs ,®Disconnect (Check One) <br /> SAC Charge (2002 rate $1,200.00) $ (Set Rate) <br /> Sac Charge must accompany all sewer permit applications unless prepaid. <br /> (If not prepaid, a sewer connection will not be issued) <br /> Municipal Sewer Connection/Disconnect/Repair ($35.00 per stub) $ <br /> pipe size inches; material Schd 40 air tested; cast iron <br /> Municipal Water Connection/Disconnect/Repair ($35.00 per stub) $ <br /> pipe size inches; material copper; other <br /> WATER METERS must be picked up and paid for at City Hall. <br /> Water meters must be set and sealed by Orono Water Department <br /> (952-249-4600) upon completion of meter installation. <br /> REQUIRED minimum setbacks from drain field and septic tanks = 75' <br /> REQUIRED setback from sewer line=20' <br /> PERMIT FEE CALCULATION <br /> 1. Subtotal of above permit requested $ <br /> 2. State Surcharize $ .50 (Minimum) <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 (Mail In Only) <br /> 4. TOTAL PERMIT FEE (add lines 1-3 above) $ <br /> The undersigned hereby applies to the City of Orono for issuance of a Utility Permit, agrees to do all work in strict <br /> accordance with the ordinances of the City and the regulations of the State of Minnesota, and certifies that all statements <br /> made on this application e complete, true and correct. <br /> Signature ofApplic � o � Date: <br />