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' i-04-2001 12:4dpm Prom-CITY OF ORONO +0522404616 T-2oT P.001/001 f-305 <br /> • � �uE+car�ou aia��u1) <br /> CITY OF ORONO A.PPLiCATYON FUR UTILTTY PER.MTTS <br /> BoY Gd(2750 KaUey Parkway) SEWER/WATER <br /> Crystal Bay,MN 55323 <br /> CEN L II�IFORMAT�QN <br /> 1. You mey sppty for�atility paemiu by mall or ui persan atthe City officea <br /> 2. Mailed tn applications are subject to the postage and han�ing fee showa below. Permit cards will be sent by <br /> return mnil tbt same day the applieation Is rocuivad, <br /> 3, Pecmits are aot vaJid until yoa roo�fve a petmit esrd. <br /> � 4. Wa�ic must not begin unlesa�e pemilt card la avail8ble aa the job site. <br /> S. Utility connxtion pennits may be issued to licens�d cantractors only. <br /> � 6. Coatact the Public Works Departmeat (95?-249�600) for uu'liry swb bs-built locations. pQ NOT <br /> QCCAVAT'8 IN ANY S'IREET AND DO NC�T TAP ANY MAIN witho�t express approval of the Public <br /> Warks Departmea� [ssuanca of a perm�t does not�ant this npproval. <br /> 7. AR wo�k muat be deae in accorc�ncce with Stm e Code roquireiueats. <br /> , H. AA wark must bc enspocted b�fore it is covera f. Gdl(452)249-4b00. <br /> 24 hour notiee req�ired. <br /> ---, <br /> .roa sr�`��nnpx�ss: -��'v�`�` �'h���:���, ���?��;-�.,�'� <br /> Occupaucy'I�pe: k Rrsidentiat Commerciai <br /> OVvuer'R 1�Is�C; =�c�<••�---� ���n`.'-���=�� ,k�,�,.�,�=�,' Phoae Number: <br /> �,- - <br /> Maili.n�Atidre��:.i_�zr,,+-�.�,a-, �,�,a.�����--�� • Cityc�. = T�x 4�5-��► <br /> Contractor'aNa�e� �;t � •. C , PLaacNumber:`l� - � _ �, 'l i <br /> MsilingAddras:.1SC'i •\ [ _ ��i'�1��:'� - 1�'i¢ CI�/:�~��,,�1 ifktC..1M(o. �t�-'�---�1-1` <br /> P��T TYP� <br /> Munictpal Sewer Conncction (S35A�per stub} $ ��_� , CC: � <br /> 1/���� pipe size�_inches; material,,,�„Schedule 44 air tested; cast iron <br /> �""'�' SAC Chnrge(2400 rate$1,150.Q0}must acco�pan�aIl sewtr ptrmit applications unless prepaid <br /> �� r If not prepaid,a aewer connection permit will�wt bc issued. <br /> Municipal'I�Ater Connection{�35.00 per stub) $ ����v <br /> pipe aiu�,�-t inches: matcrial��,,,.copper; other <br /> WATER METERS must be pick,ed up and paii!for at City Hall. <br /> R'ater metera mast be act and sealed by (lrono Water Depar�m�nt (952-?A9-4600) apon <br /> compledon of inet�r InstxUsttion. <br /> REQU�minimum satbacks from drdin field and septic t�nks=75' <br /> REQCJrYR�D sctb8ck$om sewer line=�0' , <br /> PF��FE�AL�IILAT14rt <br /> l. 3ubtotal of abovc perinit roqucstcd $ `�1 E`:�_(�� <br /> 2. S�ts.�z�..-�c�ze $ .50 <br /> Tbe State Huilding Code Divts�n SurehaTge oi�.SO per perrnit must be <br /> �aoluded for eaari well,sewor and watar conaa�3ion permit requrstecL <br /> 3. Pastage.&�andli�g(Only mail-in applications) � �� <br /> 4. TOTA.L PERNIIT FEE(ndd linos 1-3 above) � '1 f�. � <br /> The undersigacd hereby applics to the City of�hono for issuancx af a Utility Permi�,agrecs to do <br /> Sll wosic in SittiCt exord�ct with thc ardinan�:es of the Cifiy and tbe re�ulations of the State of <br /> Minncsota.and certifies that all statements tnadc on this�a�plicatioa ere complete,�ue and correct. <br /> �-�., , <br /> �ignat�ue af Applicacrt�_ / ����,� � ; '�.�u���i Da�e: �- /�� �C� _ <br /> ;;;,� — <br />