Laserfiche WebLink
------- <br /> -"` FUR CiTY C�SE ONLY <br /> 'Q������1 City of Orono Date Received: _�__.,__, Pennit# <br /> P.O.13ox 66 LL �' <br /> ; � 2750 Keiley Parkway In-House SAC Determinatio��i�mpleted j S <br /> '��, �i Crystul Bey,MN 55323 � Pd �� ��.�Q� � � ��--t0 I � <br /> �^�"�' �'j''"r ,j�` (9.52)2A9-4600/Fnx(952)249-4616 Approved By(1�Required): <br /> � <br /> ^f�.� ri <br /> C1TY (JF ORONO—SEWER & WATER/GENERAL PERMIT <br /> (*Note:Some pemiits may require approval by the Building Oft"icial andior Pub:Sc V✓orks Depai'tment*j <br /> (ALL PERMI'FS- Mav be subieM to further review and ma�not be issued whea the anulication is received� <br /> GENERAL INF'ORMATION <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 permit card. <br /> 4. Work must nat begin unless the pennit card is available on the job site. <br /> 5. Utility connection permits may be issued to licerised eontractors only. <br /> 6. Contact the Public Works Dcpartment(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 Warks llepartment. Issuance of a permit does not grant this approval. <br /> 7. All work must be dane 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 /> [_]Residential(May Require Approval) �]Cornmercial(Approval Required) <br /> (� New Connection [_]Additional Cannecti�n [� Re-Connection �f Repairs ❑ Disconnect <br /> [] Water Availability Connection F'or Future Hook-Up to Water <br /> Job Site/Owner Information: i <br /> Site Address: 4� 7 S SC�,r,���� �.�C.,��: <br /> ; <br /> Owner: �--'�vV�Q.,�aL'�t, �l�l.f �� MailingAddress: 1 ��' 7� ��1,��'YL�CL(,� <br /> City: �Jl•�-�i �� Zip: �S '.>Z 7 <br /> Home Phane:��� ��7� 1P�Z tp Alternate Phone: <br /> Contractor Inf'orrnation: � <br /> Contractor. °,� � C�4-�c/�u�'�C l,4 t;itiV Contact.Persan: �t�Q-c-,(-� <br /> Address: M ���l� t�;c.1/L(.Gl�l:� �'�1�'��`� State License#: <br /> City: �������'' Zip:��� Expiration Date: <br /> Phone: ��?)����'���U AlternatePhone: �«- ���" � �`� � <br />