HomeMy WebLinkAbout2000-P02251 - sewer hook-up 1116
PERMIT
CITY OF ORONO PERMIT TYPE: Sewer
2750 Kelley Parkway -P.O. Box 66 Permit Number : Fba075/
Crystal Bay, Minnesota 55323 Date Issued: 01/31/00
(612) 249-4600
SITE ADDRESS: 60 Orono Orchard Road South
H.N.B
P. I. N. : 02-117-23 21 0023
DESCRIPTION: Sewer Hook-up
REMARKS:
FEE SUMMARY:
Fee $35.00
Surcharge $ .50
Total Fee $35.50
CONTRACTOR: Sullivan's Utility Services OWNER:
THE UNDERSIGNED HEREBY REQUEST PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED AND
AGREES TO DO ALL WORK.IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
4111,
AP' ICANT/PE' IT E SI ISSUED BY: SIGNATURE (2/
CITY OF ORONO APPLICATION FOR UTILITY PERMITS
Box 66 (2750 Kelley Parkway) SEWER/WATER
Crystal Bay, MN 55323
GENERAL INFORMATION
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 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(249-4600)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 249-4600.
24 hour notice required.
JOB SITE ADDRESS: �i 2 CYt/' o a/'eh siva( Rel,
Occupancy Type: >c Residential Commercial
Owner's Name: O,,br (A/1 ; 1- -.le Phone Number: 6/73—g'/mac
Mailing Address: (, f/ ��� ON (9k-4��vi// City: ®K0-i 9 Zip: SS 3 et/
Contractor's Name: Sr r 1/;,/,,,,,is Uf-;i; S',-' of Phone Number: L- 73-'-i 300
Mailing Address: 3 6 U II cr /al ,, City:fiUGtczG[ lap:S3—.3 /
PERMIT TYPE
Municipal Sewer Connection ($35.00 per stub) $
pipe size '/ inches; material Schedule 40 air tested; cast iron
SAC Charge ($1,050.00) must accompany all sewer permit 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 METERS must be picked up and paid for at City Hall.
(5/8" meters= $130.00; 3/4" meters= $180.00; 1" meters= $240.00)
Separate Plumbing Permit issued for water meter.
Water meters must be set and sealed by Orono Water Department(249-4600) upon completion
of meter installation.
REQUIRED minimum setbacks from drainfield and septic tanks= 75'
REQUIRED setback from sewer line=20'
PERMIT FEE CALCULATION
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: if ' Date: /-)/9'00