HomeMy WebLinkAbout1995-007629 - water meter PERMIT
� ' CITY OF ORONO PERMIT TYPE:
> '50 Kelley Parkway- P.O. Box 66 Permit Number: s'"�='
Crystal Bay, Minnesota 55323 - -
(612)473-7357 Date Issued: _
SITE ADDRESS:
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REMARKS:
FEE SUMMARY:
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i,,�'' • APPLIC P,RMITEE SIGNATURE �—� ISSUED BY:SIGNATURE
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� ' C1TY Ur O1tON0 APPLICATION FOR UTII,ITY YEKMITS
Box 66 (2750 Kelley Parkway) SEWER/WATER
Cryst�l Bay, MN 55323
GENERAL INP'ORMAT[ON
1. You may apply for 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 day the application is received.
3. Permits are not valid until you receive a permit card.
4. Work must not begin unless the pennit card is available o�i the job site.
5. Utility connection permits may be issued to licensed contractors only.
6. Contact the Public Works Department(473-7357)for utility stub as-built locations. DO NOT EXCAVATE
IN ANY STREET AND DO NO't TAP ANY MAIN without express approval of the Public Works
Departme►it. Issuance of a permit does not grant this approval.
7. nll work must be done in accordance with State Code requirements.
8. All work must be inspected before it is covered. Ca11473-7357.
24 hour notice required.
J013SITCAllllIZ�SS: �� � � C�'¢5^C—U ��C �„�U� 1l �
Occupancy Type: Residenhal Commercial
O�vner's Name: Phone Number:
M�iling Address: City: 7ip:
Contractor's Name:,,/(/ ,�_�,.�1��0�/ PhoneNumber:�� ��ZC�C�
y
Mailing Address:��f� �,� 7_�.`hn �; 7` City:� .c>l s'�-� 7�p: ;����L�6�'
PEItMIT 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 perrnit applications unless prepaid. If not prepaid,
a sewer connection permit will not be issued.
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Municipal Water Connection ($35.00 per stub) $
pipe size _inches; material copper; other
WA'I ER �"� � -mti��b6-�ic•�c�d up and paid for at City Hall. .
5/8" ineters = $135.00; 3/4" meters = $185.00; 1" meters= $240.00)
Separate P urn ing ermit issued for water meter.
Water metcrs must be set and sealed by Orono Water Department(473-7357)upon completion
of inetcr installation.
REQUIRED rninimum setbacks from drainfield and septic tanks= 75'
REQUIRED setback from sewer line=20' �
PERMIT FC� CALCULATION
1. Subtotal of above permit requested $
2. State Surchar�e $ .50
The State Building Code Division Surcharge of$.50 per permit must be
included for each well,sewer and water connection perniit requested. `
3. Posta�;e & Handlin� (Only mail-in applications) $ 1.50
4. TOTAL PERMIT P�E (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 certilies lhat all statements made on this application are coinplete, true and correct.
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Signature of Applicant: � Date:� � C �,