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. � <br /> � <br /> FOR CITYsjSE ONLY <br /> ,�0� City of Orono Date Received: — �` Permit# 0``JO y�� <br /> P.O.Box 66 <br /> ��P � 2750 Kelley Parkway ❑In-House SAC Determination Fo Completed ' <br /> ��'���`r � Crystal Bay,MN SS323 <br /> �� �T ���o` (952)249-4600 Approved By(If Required): <br /> ���, � <br /> �xos <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 annlication is received) <br /> GENERAL INFORMATION <br /> 1. You may apply for utility permits by mail ar 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 return mail within 2 business 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 connection pernuts 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 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 ❑Additional Connection ❑Re-Connection ❑ Repairs ❑ Disconnect <br /> Job Site/ Owner Information: ' <br /> Site Addre • `�Cit �// <br /> ss. � <br /> Owner: Mailing Address: <br /> City: Zip: <br /> Home Phone: Altenzate Phone: <br /> Contractor Information: <br /> Contractor: ��S tn�� d���-.��ontact Person: _ �--_�''�� <br /> Address: � i t,✓� � N�State License #: C�O v �.�� Q�/�I <br /> City: /� � Zip� /��ExpirationDate: �� — � 1 � �-� <br /> Phone: �j� - ���`''�/6� Alternate Phone: <br />