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� . <br /> - R CI'1'Y il��OTTLI' <br /> g.�.^t�� City of Orono Date Receiaed: Pe�nit# <br /> ; P.O.Box 66 <br /> 2750 Kelley Parkway �In-Ho�.se 3AC Determination Foim Completed <br /> ' ,�-� Crystal Bay,MN 55323 <br /> �`�(,�A�SHo¢�,t'� (952)249-46U0/Fax(952)249-4616 Approved By(I�'R�equ'ved): <br /> CITY OF ORONO—SEWER&WATER/GENERAL PERMIT <br /> (*Note:Some peimits may require approval by the Building Official and/or Public Works Departrnent•) <br /> (ALL PERMITS- Mav be subiect to turther review and mav not be issaed when ffie aoolication is received) <br /> GEI�ERAi,INFORMATIOI� <br /> 1. You may apply for utility permits by mail or in person at the City offices. <br /> 2. Mailed in applications are subject to the postage and handling fee shown below. Pemut cards will <br /> be sent by retuin mail within 2 business days. <br /> 3. Permits are not valid until you receive a permit card. <br /> 4. Work must not begin unless the permit cazd is available on the job site. <br /> 5. Utility connection permits may be issued to licensed contractors only. <br /> 6. Contact the Public Works Department(952-249-4600)for utility stub as-built locations. <br /> DO NOT EXCAVATE IN ANY STREET AND DO NOT TAP ANY MAIN without eapress <br /> approval of the Public Works Department. Issuance of a permit does not grant this approval. <br /> 7. All work must be done in accordance with State Code requirements. <br /> 8. All work must be inspected before it is covered. Call(952)249-4600,24+hour notice required. <br /> TY�E OF PER�IiT <br /> Check All That A i <br /> �Residential(May Require Approval) ❑Commercial(Approval Required) <br /> �New Connection ❑Additional Connection ❑Re-Connection ❑Repairs ❑Disconnect <br /> ❑ Water Availability Connection For Future Hook-Up to Water <br /> Jo� Si�e/Owr�er Infor�ation: <br /> Site Address: ��� s�y��L '�'Q , <br /> Owner: � �D /'V�� ��. Mailing Address: <br /> c�ri: OQe�vo z�p: <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> Contractor: �-�..�. �;�R►�NL 1NG� Contact Person: /��� �Xiei�✓�o <br /> Address: Zg�L ��,,iL �• State License#: <br /> City: ��•S Zip: s�3.3 Expiration Date: <br /> Phone: �5�1 �I86, /3�S Altemate Phone: <br />