Laserfiche WebLink
. �l� <br /> A <br /> FOR CITY USE ONLY <br /> � 1.���- Date Received: Pemut# <br /> ��-���- ��� City of Orono <br /> I` � P.O.Box 66 <br /> � ,p � 2750 F:elley Parkway ❑In-House SAC Determination Forni Completed <br /> �,�.�E � , \`/ Crystal Bay,MN 55323 <br /> �' � _�'��'\ (952)249-4600/Fax(952)249-4616 Approved By(If Required): <br /> �.�,.�.���r, <br /> CITY OF ORONO- SEWER& WATER/ GENERAL PERMIT <br /> (*Note:Some permiu may require approval by the Building Official and/or Public Works Department*) <br /> (ALL PERMTTS- Mav be subiect to further review and mav not be issued when the application is received) <br /> GENERAL 1NFORMATION <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 card 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 /> TYPE OF PERMIT <br /> (Check All That A 1 ) <br /> ❑Residential (May Require Approval) ❑Commercial(Approval Required) <br /> �ew Connection ❑Additional Connection ❑ Re-Connection ❑Repairs ❑Disconnect <br /> ❑ Water Availability Connection For Future Hook-Up to Water <br /> Job Site/Owner Information: <br /> Site Address: � ��`� � �.4�V'� ����- ��'�' � <br /> � �, � ���'-� Mailin Address: ��`'�� �-` � ��'�' <br /> Owner: `�N�ci v r g <br /> City: �`�= Zip: <br /> Home Phone: �S�Z- 3`�lS` -G�G� Alternate Phone: <br /> Contractor Information: <br /> Contractor: ��C�C � ���" Contact Person: �--�i�"� ��``��`'— <br /> pQ (�cy'-�'73 l.� G 3� <br /> Address: (lYG( Cc; ��- � State License#: <br /> � j z -3l�ls�-- <br /> City: 7�A���� Zip:-5��4�) Expiration Date: . <br /> Phone: `!SZ- 93�-`�L33 Alternate Phone: <br />