HomeMy WebLinkAbout1993-005066 - replace water meter PEI�MIT
CITY OF ORONO `� � � PERMIT TYPE:
2750 Kelley Parkway • P.O. Box 815 Permit Number: ������`���''
Orono, Minnesota 55356-0815 ''�'�`-'�_'�='
(61�) 473-7357 Date Issued: �y�j�,�1_�;:;
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APPLICANT/PERMI E SIGNATURE ISSUED BY:SIGNATURE
CITY OF ORONO APPLICATION FOR DTILITY PERMITS
Box 66 (1335 So Brown Rd) y ' SEWSR WATER
Crystal Bay, MN 55323
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i: You mai y pply�tor utility permits by mail or in person at the City offices.
2. Mailed in applications are subject to the postage and handling fees shown below.
Permit cards wil 1 be sent by return mail the same day the application is received.
3. P�ennits are nat valid tmtil you reveive a �*�+;t card.
4. Work must not beqin unless the permit card is available on the job site.
5. Utility connection permits may be issued to licensed contractors only.
6. Contact the Public Works Departme.nt (473-7357) for utility stub as-built locations.
DO NOT EXCAVATE IN ANY S'IREE,T AND DO NOT TAP ANY MAIN without express approval of the
Public Works Department. Issuance of a permit does not grant this approval.
7. All work must be done in accordance with State Code requirements.
8. All work must be inspected before it is covered. Call 473-7357.
24 haur natioe requirea.
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JOB SITE ADDRESS: � � ���' :•d�,-�d^�� +;<���� r�� v�=���+,;,
Occupancy Type: Residential Commercial
OWNER'S NAME: %�; �. �{.�,n,�,. �J/�' ,�� Phone No. :
Mailing Address: i :,:,, - -�,.`, u�;,��, City: %•�: ��_
CONTRACTOR'S NAME: ���i,� / ,;'/���,� ��'c Bus. Phone: ���� ���� �� i
Mailing Address: i f 3i �r�/�,., :- ;-� City: �' ,�/„��:; i;..i Zip: �°����x :�
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---y PERMIT TYP$ AND F$$ CALCIILATION
MIINICIPAL SEWER CONNECTION ( $30 .00 per stub) $
pipe size inches; material PVC fon sand fill ) ; cast iron
SAC Charge ($700.00) must accompany all sewer permit applications unless
prepaid . If not prepaid, a sewer connection permit will not be issued.
MIINICIPAL WATER CONNECTION ($30. 00 per stub) $
pipe size inches; material copper; other
WATER METERS must be picked up and paid for at Ci _liall..-------------
(5/8" meters = $133. 00; 3/4" meters = $181. 00; 1" meters = $235. 00) �'
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Water meters must be set and sealed by Orono Water Department (473-7357)
upon co�pletion of ineter instal lation.
REQUIRED minimum setbacks f rom drainfield and septic tanks = 75'
REQUIRED setback from sewer line = 20 '
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l. Subtotal of above permit requested $
2. State Surcharge .50
The State Building Code Division Surcharge of .50 per permit must be
included for each well, sewer and water connection permit requested.
3 . Postage � Handling (Only mail-in applications) $ 1.50
4. TOTAL P$RLKIT FEE (add lines 1-3 above) $
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The undersigned hereby applies to the City of Orono for issuance of a Utility Permit,
agrees to do all work in strict accordance with the ordinances of the City and the
regulations of the State of Minnesota, and certifies that all statements made on this
application are �lete, true and correct.
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Signature of Applicant: �/ ��. ' !�'; �=J Date:
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