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10l19l2017 10:54 FinalGrade �J�q952 A92 5101 P.002l006 <br /> . <br /> - �� FaR crr�vs�rnv�,Y <br /> �td/1%Q city of orono Date Rexrvea: Pennit# <br /> P,O,Box 66 <br /> 2750 Kelley Perkwny Q In-Haae SAC Determ4�etlon Pam Complebed <br /> ;� � Z Ctystal Bay,MN 55323 <br /> f�" �w s�iow� �952)249-4b00/Fex(952)449-4616 APP�'�BY'(�'�q�)� <br /> CITY OF ORONO—SEWER&WATER/GEN�RAL PE�T <br /> {�Note:3ome permits may�equire appmval by the eididing O(Cicia)and/a Public Worka Department�) <br /> fALL PER11Q7'S-Mav be so6kct lo furlRer ravin�aod mnr cat be issuad whea the aaolScatloo b receivedl <br /> C�ENER�►L,IlV�+ORMp►TIQ� <br /> 1. You m�y apply for utility permits by mail or in person at the City offices. <br /> 2. Mailed in applications are subjeot to the posbage snd handling fee shown below. Pennit cards will <br /> be sent by retum mail within 2 business days. <br /> 3. Pe�rmits are eot valid undl you receive a permlt csrd. <br /> 4. Work must not begin unless the permit card is available on the job site. <br /> 5. Utility connection permits may be isaued to licensed contractors only. <br /> 6. Contaat the Public Works Department(952-249-4600}for utility stub as-built locations. <br /> DO NOT EXCAVA'Y'E TN AN'Y STR�ET ANb DO NOT TAP ANY MAIN wlthout express <br /> approval ot th�Public'Worlia Do�artment Issuance of a permit do�not grant this approval. <br /> 7. Al[woidc must be done ia eccordance with State Code requiramants. <br /> 8. All work must be inspected before it is covered. Call(952)249-4600,24+hour notice requfred. <br /> TYPE OF PERMIT <br /> Check AIl That A 1 <br /> �Residential(May Require Approval) ❑Commercial(Approval Required) <br /> �New Connection ❑Additionai Connection ❑Re-Connecdon ❑Repairs []Discoa�nect <br /> ❑ Waxr Availabiliry Connection For Future Hook-Up to Water <br /> Job Site/Owner Information: <br /> Site Address: L��,s,����,�����r�i� „ <br /> Qwner: �-�' " Mailing Address:� /�, <br /> City: �`��� Zip: ��'y' <br /> Home Phone: Alternate Phone: �pJ�"�.�.�� ���� <br /> Contractor Inforn�ation: <br /> Contractor:� � �,q�7'�o�ntaat Person: ��.� ���/J�� <br /> Address:(„��� State�.icense#: ,r�5�o��.. <br /> ��3�a <br /> City: �p Expiration Date: <br /> Phone: ��"�9vi"��� Alternate Phone: ,�D�o����e9"'0���9 <br />