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- FOR CITY USE ONLY <br /> i''�\,. • <br /> ,yr.q��--���1„��-'r Clty Of�TOnO Date Received: Permit# <br /> !( `'� `C P.O.Box 66 <br /> � � 2750 Kelley Parkway ❑In-House SAC Determination Form Completed <br /> ��� , Crystal Bay,MN 55323 <br /> k '�`'1 . � (952)249-4600/Fa�c(952)249-4616 Approved By(If Required): <br /> � <br /> CITY OF ORONO— SEWER & WATER/ GENERAL PERMIT <br /> (*Note:Soine permits may require approval by the Building Official and/or Public W orks DepartmenY*) <br /> (ALL PERMITS- Mav be subiect to further review and mav not be issued when the application 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 retum 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 accardance 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 /> ❑New Connection ❑ Additional Connection ❑ Re-Connection ❑Repairs isconnect <br /> ❑ Water Availability Connection For Future Hook-Up to Water <br /> Job Site/Owner Information: <br /> Site Address: / �1�� �17����� <br /> Owner:����(� /'��C��� Mailing Address: <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> Contractor�-� '��u'T������1�%(�L<<� ContactPerson: ����V <br /> Address:�� � �J� State License#: <br /> City:��'����U=� ��t'L���G% Zip����� Expiration Date: <br /> Phone:7��`��rW�'` l ( �� Alternate Phone: <br />