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Aus ?_4 07 02: 1Op Coppin 952*472*2316 p.2 <br /> � , quS 24 07 01: 16p Custo� Struetures L7D 952-473-904I P- 1 <br /> i � $.Zg-01 <br /> �t7'1�u�ora.Y s� <br /> t�of Oroao nae Reeeivet����27�A-�'a�os a / �3Jr <br /> !•�O$O�O" 2750 Kd�Pah+�aY �LrHaor SIVC 'De�a7 'as�iao Fmm C� <br /> ° �iT. ' r-A (]�rWiBar,AiV55373- <br /> ����� E�' 1�1239-�bOl� ��'�� • <br /> v.�'4 <br /> CiTY O�'OltONO—SEWER&WA'I'ER/GE!VERAL PERMIT <br /> (•Pa,e:suom pem+;u mas npe ap�'al by umBm7ding olRei�t a.u�at FuiGe wods uaratbn�'7 <br /> ( 1 PF.RMITS Edn m 6wd te fxl�ar,��+„ies s�A wav mt ba Isget ahaa IAe aodiea�ion k raeeiradl <br /> GENERAl.1NFORMATiON <br /> 1 Yon sey apply far utility peimits bv mail ac m petson at tha Citg oft�rs. <br /> 2. Adailed in applications sre sabjxt to ihe po�tage amd Lanlling fce sho�vn beiow. Pe�m�t carda will <br /> ba scnt by retum maiI wimin 2 b�ai�rs�days. <br /> 3. P�its a�e aot Taiid aMi!yon meive a permit card. <br /> 4. Wort:must�at hegia wiless d�e pe�mit ca�d is availaAle an ihe job silc. <br /> 5. Ulility connection pa�niLa tnny be issucd Io Iu:ea9ed coatradors oaty. ` <br /> 6. C�ntact thc Pub6c Wa�ics 1kPs�lmeat(952-24�1600)Cor Wility st�as-built locatiaz�s. <br /> pp NpT YJCCAVATL IN MiY SI1tEET AND DO NO�I'TAP AIYY MAW witbont cipiess <br /> appimai of the PabGc Works Dep��immt is�mooe o�a penait daas not�anR this app�oval. <br /> 7. Hll�arork m�t be dom in acxorda�aec with State Codc requi�emcn�s. <br /> R. All work�t be it�►eclod before i!ic covened. Call(952)249-460U,7 DI1T OON[C 7CqUl1'lfJ. <br /> TYPE OF PERIvIIT <br /> (�edc A117hat A <br /> �Reside�rtial(MAy Raquue ApplwaQ ❑Cammercnl(Appcovai Roqetired) <br /> Q New Coaoeeaan []Additioesl Camoection [�Re-Cooax�tia� Q Repeiis �1?iseonnoe� <br /> Job s�te�owt►a rnf«matioA: <br /> Site Address: 1�f��E�'��,it�Cr l .,t(2C'.L.� <br /> o.�r�: 9i5�_ .►�v�ttt.t n�iins aaa�: �14 �t.aC�tn1C-�'t�1 P�sti,'S�, <br /> City: ��J Zip: ����� <br /> Horiu Phone:�L'�?8� Alt�nate Phane: <br /> Contracxor tnformation: <br /> (�A t <br /> Contractor. <br /> �;,%`��iS�T �:'" �ar��,�:� Cantact Pezson: �a.�.��-- �� ` �'�'��` <br /> Address: �;-�� •+'"'�`- �i� �> State Licer�.se#: �,� �� <br /> � � <br /> �" C .ti '�' ;'rJ e j • � <br /> Ciy: a�'j,YL�'�v ' � � Zig����>�-Expiration Date: � �• • C <br /> � �. <br /> Phone: ��,�"'ti r �?�?`� Alternate Phone: iv����.�'�.L f�'t?` <br /> I <br />