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r ti <br /> � FOR CITY USE ONLY <br /> �' �0� Clty of�t'On0 Date Received: Permit# <br /> O , O P.O.Box 66 <br /> �ti�,,, 2750 Kelley Parkway ❑In-House SAC Determination Fonn Completed <br /> a �'��'�r- Crystal Bay,MN 55323 <br /> �������o� (952)249-4600 Approved By(If Required): <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- Mav be subiect to further review and mav not be issued when the aoplication is received) <br /> GENERAL INFORMATION <br /> 1. You may apply for utility pernuts 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. Wark 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 pernut 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 Apply) <br /> �esidential(May Require Approval) ❑ Commercial(Approval Required) <br /> ❑ New Connection ❑Additional Connection ❑ Re-Connecrion ❑Repairs °�'Disconnect <br /> � a <br /> Job Site/ Owner Information: <br /> , �� �� _� <br /> Site Address: � U +� s � ' <br /> Owner: Mailing Address: <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> Contractor: � ,��S�p�t ��4 ��� Contact Person: �F�v.�, C�a� �� <br /> Address: G,�O� � ,��. (� State License#: ��oY��^'/ <br /> City: (�.� � Zip:���Expiration Date: l � ���-�9 <br /> � <br /> Phone: ( � � - 'j� Alternate Phone: ����� 7�f�- S �� � <br /> � <br />