HomeMy WebLinkAbout1996-008341 (plumbing) _ --�r �_
� PERMIT
� CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 �!.._►._fi=:i=;l �,;[_
Crystal Bay, Minnesota 55323 Permit Number: �:;�:;;.r:j;��
(612) 473-7357 Date Issued: r_�,�j���f,��
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FEE SUMMARY:
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATU �
�� C1TY OF URONO APPLICATI�N FOR UTILITY PERMITS
Box 6G (2750 Kelley Parkway) SEWER/WATER
Crystal Bay, MN 55323 ,y h`��
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GGNGRAL INFORMATION
1. You may apply for utility permits by mail or in person a[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 the application is received.
3. Pcrmits 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 may be issued to licensed contractors on(y.
6. Contact the Public Works Department(473-7357)for utility stub as-built locations. DO NOT EXCAVATE
IN ANY STREET AND DO NOT TAP ANY MAIN without express approval of the Public Works
Department. [ssuance 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 noticc requircd.
JOBSIT�ADllItESS: 2`7 y� Cas c o �f�
Occupancy Type: Residential Commercial -
Owner's Name: C � i e v` Phone Numbcr: '
Mailing Address. � City-��r�++, v 7�p:
Contractor's Name: � � e /G e c y ,`c� Phone Number: (rJ j �2 v
M�iling Address: S Os� 2 2 C� S � � City: �N►nin�• n 7�p: SS42
PERMIT TYP�
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 pennit applications unless prepaid. If not prepaid,
a sewer connection permit will not be issued.
Municipal Water Connection ($35.00 per stub) $
pipe size inches; material copper; other
WATER MI;TERS must be picked up and paid for at City I�all.
(5/8" meters = $139.00; 3/4" meters = $191.00; 1" meters = $247.00)
Separate Plumbing Permit issued for water meter.
Water meters must be set aud sealed Uy Orono Water Department(473-7357)upon completion
of inetcr installation.
REQUIRED minimuln setbacks froin drainfield and septic tanks = 75'
REQUIRED setback from sewer line= 20'
I'F,RMIT F�i�, CALCULATION
l. Sublotal ol�abovc percnil rcyucsled $
2. State Surchar�e $ .50
T'he State f3uilding Code Division Surcharge of$.50 per permit must be
included for each well, sewer and water connection permit requested.
3. Posta�e & �Iandlin�(Only mail-iii applications) $ 1.50
4. TOTAL I'LRMIT FEE (add lines 1-3 above) $
"1 he ui�dersigned 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 and correct.
Si nature of f1 licant: � . Date: � � ��
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