Laserfiche WebLink
l �� <br /> � � ,� <br /> � FOR CI'TY USE ONLY <br /> O,¢D�O City of Ol'ono Date Received: Permit# <br /> PA.Box 66 <br /> . 2750 Kelley Parkway ❑In-House SAC Determi�ation Form Completed <br /> � �.�'q' : Crystal Bay,MN 55323 <br /> • ,:`o (952)249-4600 Approved By(If Required): <br /> ��w <br /> CITY OF ORONO—SEWER&WATER/GENERAL PERMIT <br /> (*Note:Some permits may require approval by the Building Official and/or Public Works Department t) <br /> (ALL PERMITS- Mav be subiect to further review and mav not be�sued w6en the aoolication l�receivedl <br /> GENERAL INFORMATION <br /> 1. You may apply for utility pennits by mail or in person at the City offices. <br /> 2. Mailed in applications aze subject to the postage and handling fee shown below. Permit cards wilt <br /> be sent by return mail within 2 business days. <br /> 3. Permits are not vaHd unril 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 locallons. <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. Catl(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 /> l� <br /> ❑New Connection ❑Additional Connection ❑Re-Connection �Repairs �Disconnect <br /> Job Site/Owner Information: <br /> Site Address: ��o�� ,���t;✓vc>� ��Q <br /> Owner: �-��"t ...X1 ���p��� Mailing Address: �b�`U �a�I.t,t oo.a' /l� <br /> City: (��''� Zip; � <br /> Home Phone: Alternate Phone: <br /> Contractor Informa ion: <br /> , <br /> Contractor: 4�' 041C1 Contact Person: �'��`� �""�� <br /> Address: 1�S3J c��� �Gt,� State License#: <br /> SI�'f�/�7 � - <br /> City: /Yl Zip: YYI Expiration Date: � ".�/�ff.�j <br /> Phone: 7(�3' ��`�" .,��f�7 Alternate Phone: 71��' S�1`" .3�1/J <br />