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� �+, r�. <br /> FO �'�� USi~� E O1�ILX ;�j� <br /> '��Q/�/���, City of Orono L`lace Rocci.edp����—Pern»t#����_� 7`t�t• <br /> ', P.O.Bax 66 <br /> ( � i 2750 Kelley Parkwuy ❑In-House SAC Detetminatiou Rocm Compieted <br /> � ' Crystal Bay,MN 55323 <br /> t��y'r�,s'� ���j (452)249-z1600 I Fux(452)249-0616 Approved By(If Required): <br /> ` �R1.9N�ttx'�=' <br /> CITY OF ORONU—SEWER&WATER/GENERAL PERMIT <br /> ("Note:Some permits may mquire apgroval by the Building O�cial and/or Public Works Department') <br /> (ALL PERMI'i'S- Mav be subiect to furti�er review aed mav not bc issuRd when fhe aapikation is received) <br /> GENERAI, INF�RMATION <br /> l. You may apply for utility permits 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. Work must not begin unless the permit card is available on the job site. <br /> 5. Uriliry 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 ezpress <br /> approvat 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 reqnired. <br /> TYPE OF PERMIT <br /> Check All That A 1 <br /> (�j'Residential (May Require Approval) ❑Commercial(Approval Required) <br /> �New Connection ❑Additional Connection ❑Re-Connection ❑Repairs ❑Disconnect <br /> ❑ Water Availability Connection For Future Hook-Up to Water <br /> Job Site/Owner Information: <br /> Site Address: J . <br /> Owner: �,�,����_ Mailing Address: �� (U��� {� <br /> City: t,IS�� Zip: �'�J'.,�� , <br /> Home Phone: Alternate Phone: �(Ll�j•J'�3-Q�l� <br /> Contractor Informatian: <br /> Contractor: �`�,,,�ylr.Y � �. Contact Person: G ` � CI�/ <br /> Address: l.v��,0(� ���� 1 V' State License#: <br /> City: � Zipt��Expiration Date: <br /> Phone: 1��.`i��• �I�� Alternate Phone: �D��• �-D�. �a� <br />