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HomeMy WebLinkAbout1992-004159 - water connect . _ . PERMIT �IT1F OF ORONO PERMIT TYPE: :l,���� �� �y�-��� � 1335 Brown Rd. South • P.O. Box 66 Permit Number. i;i_i�.�,5°:� C;r�stal Bay, Minnesota 55323 Date Issued: ���� (��2) 473-7357 ���'f'f`�' �'� SIT!�` A�JDRESS: I -:� _,�,� :=_���'t��;i It�#� ��} ""i��� _ ..:� �� ��--i i ,�1—_':_�—Lii,.{;'—(3� :i . � �"� - ' J. T.. 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Work must not begin 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 Dep�artment (473-7357) for utility stub as-built locations. Dp NOT F,XCAVATE IN ANY STRFET ADID DO NOT TAP ANY MFIIIJ without express approval of the Public Works Depaztm�nt. 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. *************************************************************************** JOB SITE ADDRESS: �I�( J �q,.,IGy [�Q-Q�� l'�C Occupancy Type: ` � esidenti 1 Commercial OWNER'S NAI�: Phone No. : Mailing Address: City: CONTRACTOR'S NAML- �-,Q-)�v a �i J�([r,,,,:��-` Bus. Phone: Ll 7 y �"�77� Mailing Address: " ' City: �;�sccLf���;. Zip: � � � ' ******************* *** ******* ***************************************** �. P$RMIT TYPE AND F$E CALCIII,ATION MIINICIPAL SEWER CONNECTION ($30. 00 per stub) $ pipe size inches ; material PVC (on 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 c�opper; other ' c u an .�� F�� �� City Hall. (5/8" meters = $133. 00;� 3 4" 'm t s � $181. 00� 1" meters = $235. 00) Water meters must be set an sealed by Orono Water Department (473-7357) upon campletion of ineter installation. REQUIRED minimum setbacks from drainfield and septic tanks = 75' REQUIRED setback from sewer line = 20 ' **************************************************************************� l. Subtotal of above permit requested $ 2. State Surcharge .50 The State Building Code Division Surcharge of .50 per permit must e included for each well, sewer and water connection permit requested. 3 . Postage � Handling (Only mail-in applications) $ 1. 50 4. TOTAL P$RMIT FEE (add lines 1-3 above) $ *************************************************************************** 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 complete, true d�orrect. � � — �' � � Signature of Applicant: Date: ��� !I ��� wi e`�e-f' . .. _• ` 07 �" 1(Q3o1 �ea��- � '' � ` � :-� � � � �