HomeMy WebLinkAbout1995-05-08 Application for Sewer Permit. CITY OF ORONO APPLICATION FOR U'I'ILII'Y PERMI'T'S
Box 66 (2750 Kelley Parkway) SEWER/WATER
Crystal Bay, MN 55323
G F: N F.R A I. INFORMATION
I. You may apply for utility Permits by mil or in icrson at the City offices.
2. Mailed in applications are subject to the Postage and handling fees shown below. Permit cards will be sent
by return mail the same day me application is received.
3. Pmnit are not valid until you receive a permit card.
4. Work must not begin unless the permit card is available on the job site.
5. Utility connection permits nuy be issued to licensed contractors only.
6. Contact the Public Works Dcpartmcni (473-7357) far utility stub as -built locations. DO NOT EXCAVATE
IN ANY STREET AND DO NOT TAP ANY MAIN without express approval of the Public Works
Depanrncnt. 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 hour notice required.
JOB SITE ADDRESS:_
_
Occupancy Type:
Residential Commercial
Owner's Name
Phone Number:_
Mailing Address:
_
City:__ Zip:
Contractor's Name:
PhoneNuimba:
Mailing Address:_
City: Zip
PERMIT TYPE
Municipal Sewer Connection ($35.00 per stub) $
pipe size inches; material PVC (on sand fill); cast iron
SAC Charge ($850.00) must accompany all sewer permit applications unless prepaid. If not
prepaid, a sewer connection permit will not be issued.
Municipal Water Connection ($35.00 per stub) 5
pipe Sire _ inches; material copper; other
WATER METERS must be picked up and paid for at City hall.
(5/8" meters = $133.00; 3/4" meters = $181-00; 1" teeters = $235.00)
Separate Plumbing Permit issued for wa --r meter.
Water meters must be set and sealed by Orono Water lkpartnsent (473-7357) upon
completion of meter installation.
REQUIRED minimum setbacks from drainfield and septic tanks = 75'
REQUIRED setback from sewer line = 20'
PERMIT FEF CALCULATION
1. Subtotal of above pcniiit requested 3
2. Slate Surcharge 3 5t1
Tile State Building Code Division Surcharge of $.So per pernil must be
included ler each well, sewer and water connection permit requested.
3. Postage & handling (Only mail -in applications) S 1.50
4. TOTAL PERMIT PEE (add lines 1-3 above) 3
The undersigned hereby applies to the City of Orono for issuance of a Utility Permit, agrees ht
do all work in strict accordance with the ordinances of the City and the regulations of the State
of Minnesota, and certifies than all statements made on this application are complete, true and
correct.
Signature of Applicant:_ DLL::