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HomeMy WebLinkAbout1993-05-17 Application for Utility PermitJCITY OF ORONO APPLICATION FOR UTILITY PERMITS Box 66 (1335 So Brown Rd) SEWER WATER Crystal Bay, MN 55323 I: You may app y or 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 will be sent by return mail the same dayy the application is received. 3. Pezmits are not valid until you receive a permit cmrd. 4. Fbrk must not begin unless the permit card is available on the job site. 5. Utility connection permits may be issued to licensed oontractors only. 6. Contact the Public Works Department (473-7357) for utility stub as -built locations. DO NOT MokVATE IN ANY STREET 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 how notice required. JOB SITE ADDRESS: 41•l Occupancy Type: L Resi a tial Commercial 011HRR' S NAME: Phone No . : Mailing Address: City: ©OITRACTOR' S NAME: Bus. Phone Mailing Address: zip: �S *�***�*�A*+kf1�t►*f�►*�*��****�**err***�t***��*******�***�!�*** '�c ��; ��. PERMIT TYPE ACID FEE CALCULATION MUNICIPAL SEWER COMMerIOM ( $3��9fl per stub) $ � ",I " pipe size inches; material PVC (on sand fill); cast iron SAC Charge ($700.00) must accompany all sewer permit applcations unless prepaid. If not prepaid, a sewer connection permit will not be issued. 3�.(I MUNICIPAL WATER CONNECTION ($36Ts6 per stub) $ pipe size inches; material copper; other WATER METERS must be picked up ana'paid for at City Aa (5/8" meters - $133.00; 3/4" meters - $181.00; 1" meters - $235.00) Water meters must be not and sealed by Orono Water Department (473-7357) upon completion of meter installation. REQUIRED minimum setbacks from drainfield and septic tanks - 75' REQUIRED setback from sewer line - 20' 1. Subtotal of above permit requested $ 2. State Surcharge .50 The State Building Code Division Surcharge o per permit muse included for each well, sewer and water connection permit requested. 3. Postage a Handling (Only mail -in applications) $ 1.50 4. TOTAL PERMIT 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 oa:plete, true a90'oorrect , Signature of Applicant: - Date:�'-