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� <br /> y FOR ITwT �E ONLY I� • � <br /> '`�"'� Clt Of OrOno Date Received: �� f� ermit# <br /> ,-'.�,o.�,� r �,; <br /> �� O� P.O.Box 66 � � ,N j�n <br /> n;;;; 2750 Kelley Parkway In-House SAC Determinahon Form Completed `��" <br /> � ��r�, ;. �. Crystal Bay,MN 55323 <br /> ��?�,�r-�,��yE� (952)249-4600 Approved By(IfRequired): <br /> �!rtas,n�� <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 auplication 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. 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. 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 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 A 1 ) <br /> �Residential(May Require Approval) � Commercial(Approval Required) <br /> � New Connection �Additional Connection �Re-Connection �Repairs ❑ Disconnect <br /> Job SiteJ Owner Information: <br /> � - � � ` , ` i ' <br /> �.., <br /> Site Address: -�.� i � _� � ��� ��� (f "� � c.�' G �i � u� <br /> Owner:�`lC� � �'- V�. �G� � �,y' Mailing Address: <br /> / <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor Infonnation: <br /> �. � i� � ' � <br /> Contractor: ��' 9 � � 1� Contact Person: �G�l Y1 �' �- <br /> (� > <br /> Address: ���� I �%�� ���� �� � S State License #: �� �� `�` �� <br /> City: v�1� 1l1 h � �(�` S���Zip: Expiration Date: ` � � 7 �• � � <br /> Phone: � � � � � V � }-��--� Alternate Phone: �� �� � 7�— � �� � �% <br />