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FOR CITY USE ONLY <br /> ,��� City of OrOnO Date Received: Permit# ' <br /> O.. O P•O.Box 6G <br /> �;t 27�0 Kelley Parkway ❑in-House SAC Determination Forrrt Completed <br /> ,��5�y�;" � Crystal Bay,MN 55323 <br /> ��^ 'r�,}��r��.�o� (952)249-4600 Approved By(If Required): <br /> �$sao$ <br /> CITY OF ORONO—SEWER & WATER/ GENERAL PERMIT <br /> (*Note:Some pennits may require approval by the Building Official and/or Public Works Department*) <br /> (.4LL PERMITS- Mav be subiect to further revie�v and mav not be issued when the lpnlication is reccived) <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. Urility 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 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 /> �Iew Connection ❑Additional Coimection ❑ Re-Connection ❑ Repairs ❑ Disconnect <br /> Job Site/ Owner Information: <br /> Site Address: � ✓ ��s � �. r 2 <br /> Owner: Mailing Address: <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> � r <br /> Contractor: a � Contact Person: ` <br /> Address: � ��ta w{���� State License #: <br /> � D 'l <br /> City: �� Zip!;, 7 Expiration Date: / � ?j r (/ � <br /> Phone: �j�,,-g r y l� �--�/� Alternate Phone7` � b 7� � <br />