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r <br /> ; . <br /> FOR CITY USE ONLY <br /> ,��� Clty Of OCOnO Date Received: Permit# ' <br /> P.O.Box 66 <br /> ��;,,,.,,,, � 27j0 Kelley Parkway ❑Tn-House SAC Determination Form Completed <br /> a ��'� �'' �. Crystal Bay,MN 55323 <br /> ��t������-s,��o� (952)249-4600 Approved By(If Required): <br /> '��axo$ <br /> CITY OF ORONO—SEWER & WATER/ GENERAL PERMIT <br /> (*Note:Some permits may require approval by the Building Ofticial and/or Public Works Department*) <br /> (ALL PERMITS- Mav be subiect to further review and mav not be issued when the annlication is received) <br /> GENERAL INFORMATION <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. Permit cards will <br /> be sent by return mail within 2 business days. <br /> 3. Permits are not valid until you receive a pernut card. <br /> 4. Work must not begin unless the peinut card is available on the job site. <br /> 5. Utility connection permits may be issued to licensed conh•actors 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 express <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 /> TYPE OF PERMIT <br /> (Check All That Apply) <br /> esidential(May Require Approval) ❑ Commercial(Approval Required) <br /> �w Connection ❑Additional Comiection ❑ Re-Connection ❑ Repairs ❑ Discomlect <br /> Job Site/ Owner Information: <br /> Site Address: C� ���/� � <br /> � �/ _ � i2 <br /> Owner: Mailing Address: <br /> City: Zip: <br /> Home Phone: Altemate Phone: <br /> Contractor Information: <br /> . <br /> Contracto � G�_,�� W Contact Person: / <br /> Address� � � / f� ��� U� State License #: � <br /> City: �/�'+� Zip���xpiration Date: / � ?j� � �� <br /> -+�— <br /> Phone: � ��� �/y d Z �7 Alternate Phone: �G�y��� � � 'Z� <br />