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� <br /> i � •� <br /> � <br /> FOR CITY USE ONLY � �,�� / L�(� <br /> �1Z��Nf, City of O�bno Dare Received: Pmm�a����l�f � 7 <br /> P O.Box 66 �— <br /> 1 �750 Kelley pa�ic�vay ❑In-House SAC Determwehon Fonu Completed <br /> � . Crystal Bay,VIN 553�3 <br /> '�r �'�'�,.��`, (952)249-4600;Fax(952)349-4616 Approti>ed By(If Reqwred): <br /> �,.:,..,. <br /> CITY OF ORONO—SEWER& WATER/GENERAL PERMIT <br /> ('Note:Smtte penuits may require approeal by tHe Bu�ldix�a Offic�al asul`or Pnblic Warks Depa�Ymrnt•) <br /> (ALL PERMI7'S- ltav bs aabiee!to further rerieN•and ma�•sot be issued w6ea the anolicatiou is receir•ed) <br /> GENERAL INFORMATION <br /> ' 1. You inay apply for utility pe,nnits 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 rehun mail within 2 business days. <br /> 3. Permits are not vslld untU yoa recelve a peiwit ca��d. <br /> 4. Work mc�st not begin wiless the pennit ctud is available on the job site. <br /> S. Utility connection petmits may be issued to licensed contractors only. <br /> 6. Contact the Public Works Department(952-249-4600)for tttility shxb as-built locations. <br /> DO NOT EXCAVATE IN AhY STREET AND DO NOT T�iP Al\'Y MAIN witLont express <br /> approvAl of tLe Public Works Department. Issuance of a permit does not grant this approval. <br /> 7. All vvork r�iust be done in accordance witli State Code requirements. <br /> 8. All work must be inspected before it is covered. Call(952)249-4600,24+hour notice t�equii�ed. <br /> TYPE OF PERMIT <br /> Check All That A 1 <br /> �Residentiat(May Require Approval) ❑Commercial(Approval Required) <br /> �New Connection ❑Additional Connection ❑Re-Connection ❑Repau�s ❑Discomiect <br /> ❑ Water A��ailaUiliry Connectiou For Future Hook-Up to Water <br /> Job Site/Owner Iaformation: <br /> Site Address: �p9 �..�[_'in�.£��n_� �I Y C�2, <br /> Owner: Mailing Address: <br /> City: Zip: <br /> Home Phoue: Altarnate Phone: <br /> Contractor Information: <br /> Conh�actor: 4 Q,Yb�. Cantact Person: _I�v�„ � YO/r� <br /> masohYy., c. <br /> Address: 91Gv �L�i iMUIl2. c'� l�� State Licanse#: <br /> City: �_W2_ Zip:�S�{�1 Expiration Date: <br /> Phone: �1 S�3-��'D5-b�ir6$ Alteinate Phone: �(o��— (,�5—�$7 <br />