HomeMy WebLinkAbout1992-004834 - water meter PERMIT
CITY OF ORONO PERMIT TYPE: F L 1.J M R T N
1335 Brown Rd. South - P.O. Box 66 Permit Number:
Crystal Bay, Minnesota 55323 Date Issued:
(612) 473-7357
SITE ADDRESS:
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APPLIC4T,f5ER`MITEE SIGNATURE ISSUED BY:SIGNATURE�
CITY OF ORONO APPLICATION FOR UTILITY PERMITS
Box 66 (1335 So Brown Rd) SEIER WATER
Crystal Bay, MN 55323 Y` 3
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ou maI ya 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 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 hour notice required.
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JOB SITE ADDRESS:
Occupancy Type: ✓ Residential Commercial
OWNER'S NAME: �� ����.� ti �- Phone No. : -+ -1 I - c �1
Mailing Address:, City:
CONTRACTOR'S NAME: `err.. ��st�u„�"���-� � Bus . Phone:
Mailing Address : -44ec 777777-77, 7E)" , City: Zip: S-�
PERMIT TYPE AND FEE CALCULATION
MUNICIPAL SEWER CONNECTION ( $30 . 00 per stub) $
pipe size inches ; material PVC (on sand fill ) ; cast iron
SAC Charge ( $700.00 ) must accompany all sewer permit applications unless
prepaid . If not prepaid , a sewer connection permit will not be issued.
MUNICIPAL WATER CONNECTION ( $30 . 00 per stub) $
pipe size inches ; material copper; other
WATER METERS must be picked up and paid for at Cit Hall.
(5/8" meter $133 . 00 ; 3/4" meters = $181 . 00 ; 1" meters_= $235. 06
Water meters must be set 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 = 201
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1. Subtotal of above permit requested $
2 . State Surcharge . 50
The State Building Code Division Surcharge of .50 per permit must be
included for each well , sewer and water connection permit requested.
3 . Postage & 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 complete, true and correct.
Signature of Applicant: Date :