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e ' <br /> c <br /> 4 <br /> EOR CITY USE ONLY��1 j U��� <br /> �0� City of Ot'ono Date Received: . Permit# i" <br /> P.O.Box 66 <br /> ��; � 2750 Kelley Park�vay ❑In-House SAC Determination Form Completed <br /> '�����. � Crystal Bay,MN 55323 <br /> ��l a'�,,���i�}b�o` (952)249-4600 Approved By(If Required): / <br /> '�rasxp4` � <br /> CITY OF ORONO— S�WER & WATER/ GENER.AL PERMIT � '�(� � 5 <br /> (*no te:Some permi ts may r e quir e a p p r o v a l b y t h e B u i l d i n g O f t i c i a l a n d/o r P u b l i c W o r k s D e p a r t m e n t*) <br /> (ALL PERMITS- �'iav be subicct to further review and mav not be issuecl when the apnlication is received) <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 are subject to the postage and handling fee shown below. Pernut cards will <br /> be sent by rehirn mail�vithin 2 busuiess days. <br /> 3. Permits are not valid until you receive a pernut card. <br /> 4. Work must not begin unless the peinut card is available on the job site. <br /> 5. Utility coimection pemzits may be issued to licensed conhactors only. <br /> 6. Contact the Public Works Department(952-249-4600)for utility shib as-built locarions. <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 pemut 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. Call(952)249-4600,24+hour notice required. <br /> TYPE OF PERMIT <br /> (Check All That APPlY) <br /> �Residential(May Require Approval) ❑ Commercial(Approval Required) <br /> ❑ New Connection ❑ Additionai Comiecrion ❑Re-Connection ❑Repairs �Disconnect <br /> ; , <br /> � � <br /> Job Site/ O�mer I�-if'ormation: <br /> Site Address: �` `� ��'�E �� ✓/� <br /> Owner:� ��. �me� Mailing Address: <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> ��S��ar���� �P�� J�i �'ti���� r�n� <br /> Contractor: Contact Person: <br /> Address: 1���� (,��,� �l� �� State License #: <br /> City: ��Q�`�`", �lr� Zip: Exp�ration Date: <br /> (�r� c�� � <br /> Phone: � Alternate Phone: <br />