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, , . � <br /> .___--. F'�Qlt T�`1' dM.Y <br /> �'�1.O1,I� City of Orono 1�afe Raceive�: F'�m�t# <br /> � \ P.O.Box 66 <br /> i � 2750 Kelley Parkway ❑bi-Hor�se St4C De.te�nination Fc�Compioted <br /> ,y ,�- Crystal Bay,MN 55323 <br /> �`"�,�kFsr�oA``/ �952)249-4600/Fax(952)249-4616 t�p���'{��q��� <br /> .....�•'r . <br /> CITY OF ORONO-SEWER&WATER/GENERAL PERMIT <br /> (*Note:Some pertnits may require approval by the Building Official and/or Public Works Department*) <br /> (ALL PERMITS- Mav be subiect to further review and mav not be issued when the aoolication is receivedl <br /> GENERAL INFO�ATIUN <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 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 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 /> TY�E OF PERh�iT <br /> C�ck All Tf�at A � <br /> ❑ Residential(May Require Approval) ❑Commercial(Approval Required) <br /> f�ew Connection ❑Additional Connection ❑Re-Connection ❑Repairs ❑Disconnect <br /> � ❑ Water Availability Connecrion For Future Hook-Up to Water <br /> 1ob ���I Own��r�f�rra��: <br /> Site Address: � G G � ��� C S ���. �� <br /> �- <br /> , Owner: �� �O�� ����� Mailing Address: <br /> City: ll/I�C_-1 Zip: <br /> Home Phone: ��s � �5�� Alternate Phone: <br /> Co�tra�#ar Inforn�ation: <br /> , `�' �.0�� <br /> Contractor: �� (�� � ��`'S Contact Person: � C� <br /> Address: ��Y�� G= �'� � State License#: P b G��� �3 <br /> . `� ( 2. -3c C.f � <br /> City: � ��s Zip:�sj Expiration Date: <br /> Phone: Alternate Phone: �S"� �-3 � Y133 <br /> ���' � G� �s G�� <br />