HomeMy WebLinkAbout1990-002944 - water connection PERMIT
CI�Y O� ORONO PERMIT TYPE: :�;�,;�:��; �� �,:�;T��=;
1' i Rd. South • P.O. Box 66 Permit Number: '-���`��'=j��
C � ;, Minnesota 55323 Date Issued: ;��=���-�� ` =�t}
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APPLICANT-PERMITEE SIGNATURE ISSUED BY:SIGNATURE
CITY OF ORONO APPLICATION FOR UTILITY PERMITS
Box 66 (1335 So Brown Rd) SEWER WATER WELL ; �.N
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Genes�al Instructions
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 nntil yon 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 only.
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. 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 honr notice reqaired. ��
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JOB SITE ADDRESS: �.�,5 �?� � /'`--�-�,1.-�� 4--'v�_ �,
Occupancy Type: Residential.� Commercial
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Mailing Addres� City:
�CONTRACTOR'S NAME: �� ���� „�,� •, f�'lC5 Bus. Phone: ��3�`�73 �_3
Mailing Address: ;`. ,�� `" C�-.-� ,�-� City: � � „�; Zip: ',��.�y�
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PERMIT TYPE AND FEE CALCULATION
MIINICIPAL SEWER CONNECTION ($30.00 er stub) $
�i�e size �inches; material �PVC (on sand fill) ; cast iron
SAC Charge ($575.00 ) must accompany all sewer �ermit applications unless
Frepaid. If not prepaid, a sewer connection permit will not be issued.
MIINICIPAL W TER CONNECTION ($30.00 �er stub) $
�i�e size �inches; material /C copper; other
WATER METERS must be picked up and paid for at City Hall.
(5/8" meters = $111.30; 3/4" meters = $146.28 )
Water meters must be set and sealed by Orono Water Department (473-7357)
upon completion of ineter installation.
PRIVATE WELL INSTALLATIONS ($30.00 per job) $
Check: New Replacement Repair
Casing size: inches
REQUIRED minimum setbacks from drainfield and septic tanks = 75'
REQUIRED setback from sewer line = 20 '
CAI,L FOR A SITE LOCATION BEFORE DRILI,ING
Upon completion, City must be sent a copy of State Well Record.
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1. Subtotal of above permit requested $
2. State Surcharge .50
The State Building Code Division Surcharge of .50 per �ermit must be
included for each well, sewer and water connection permit requested.
3. Postage & Handling (Only mail-in applications) $ 1.50
4. TOTAL PERMIT F$E (add lines 1-3 above) $
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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 and correct.
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SignaturE of A�plicant��'"� �L�,.`, i_ �,_ �,.,...� Date: _S �_ t, , _��,
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� D��� TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED l� - ��—�� -��
PERMIT NO. �9�F �l9`� COMPLETED �_ t
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OWNER ONTR.�/Li n�
TELEPHONE NO.
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~ ❑ FRAMING ❑MECHANICALFINA� ❑WELLTESTPUMP
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Z ❑ FINAL ( ❑METER SEflfURN ON ❑TREE REMOVAL
Q ❑DEMO—SITE �SEWER HOOK-UP %�4�3 ❑SITE INSPECTION
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J ❑ DEMO—FINAL ❑SEPTIC MAINT. ❑ PROGRESS
W PLUMBING RI ❑SEPTIC INSTALL ❑COMPLAINT
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❑CORRECT UNSAFE CONDITION WITHIN HOURS. TEMPORARY
INSPECTOR WILL REfURN
PERMANENT
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
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DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED � �
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INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Ca11 for the next inspection 24 hours in advance.473-7357
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