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� . � <br /> FO/R CI U E ONLY�7 <br /> �'��–�f� Clt�'Of�l'OIlO Date Receiv�7/ Permit#v�-�� — �� � <br /> ii j P.O.Box 66 � <br /> ! �g � 2750 Kelley Parlcway ❑In-House SAC Determination Form Completed <br /> �t :\� , . Crystal Bay,MN 55323 <br /> t 952 249-4600/Fax 952 249-4616 A roved B If Re uired <br /> � � ,�,,�, y. � (. ) � ) PP Y� 9 )� <br /> CITY OF ORONO— SEWER& WATER/GENERAL PERMIT <br /> (*Note:Some permits may require approval by the Building Official and/or Public Works Department*) <br /> (ALL PERMITS- Ma� be subiect to further review and mav not be issued when the appGcation is received) <br /> GENERAL INFORMATION <br /> l. 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 Warks 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 wark 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 ly) <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: o��o`��� —Sft� S-(b9-�. !�- � <br /> Owner: �k��-� �✓����=^-S Mailing Address: ��C� l C� � kT��v � <br /> City: �/%l'�=� Zip: <br /> Home Phone: I SZ" ��l S�G �� Alternate Phone: <br /> Contractor Information: <br /> Contractor: � �-S�' �-S� Contact Person: J ` �`' �3C`�C'�`� <br /> � ., <br /> Address: ((�G� C`' `� -3 State License#: �3 6�� Y 7 3 <br /> City: �o<<��� Zip:-S��-�v�Expiration Date: ��7 l✓�'3�_ f S <br /> Phone: �S`Z- `�-3� -`=(L 3� Alternate Phone: <br />