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� r <br /> $�� City of Orono Date R �O�� <br /> «�� p�� ao, : � <br /> � ; P.o.sox 66 <br /> 2750 Kdky Parkway �In-Honse SAC Determinedi�F�m Completed <br /> s Crystal Bay,MN 55323 <br /> �`�,�x�Se o4�,�� (952)249�600/Fax(952)249-4616 APP�'�BY��9u�'od;l: <br /> CITY OF ORONO—SEWER&WATER/GENERAL PERMIT <br /> (•Noh:Sane pamits maY roQuine approval by the Building Official and/or Public Works D�•) <br /> ��.T.p���`- M!V Dt lUbittt tn further'r�[vlCw and mav ant M i�nttl w IMn M��nnliw.N..�L�.�.t..�� <br /> GE��iERAi,INFORMATIOl� � . <br /> 1. You may apply far utility permits by mail or in peison at the City offices. <br /> 2. Mailed in applications are subject to the postage and handling fee shown below. Pecmit cards will <br /> be sent by return mail within 2 business days. <br /> 3. Permits are not valid unttl.yon receive a permit card, <br /> 4. Work must not begin unless the permit card is available on the job site. <br /> S. Utility connection permits may be issued to licensed cantractors anly. <br /> 6. Contact the Public Works Department(952-249-4600j for utility stub as-built locations. <br /> DO NOT EXCAVATE IN ANY STREET AND DO NOT TAP ANY MAIN wlthout ezpress <br /> apprnval of the Pnblic Works Department. Issuance of a permit does not grant dris approval. <br /> 7. All work must be dane in accordance with State Code requirements. <br /> 8. All work must be inspected before it is covered. Call(952)249-4600,?4+honr notice required. <br /> ' TYP�OF PER�T . <br /> Check A11 That A: ,. <br /> �Residenrial(May Require Approval) ❑Commercial(Approval Required) <br /> �New Connection ❑Additional Connection ❑R�Connection ❑Repairs ❑Disconnect <br /> ❑ Water Availability Connection For Future Hook-Up to Wator <br /> Jab S�te/()vvp�r L�o�ation: <br /> Site Address: �� Z d �l�..c,.� y w � a d� <br /> Owner: Mailing Address: . <br /> City: �r� � � Zip: <br /> Home Phone: Alternate Phone: <br /> Contract�or Tirforma�ion: <br /> Contractor: �a� ��� �-��� 5 Contact Person: ��� S��"--,- � <br /> Address: i l`-1 � ( C o �--� 3 State License#: � �`{ `{ `-( �� <br /> City: ���P�`^� 5 Zip: SS 3�c 3 Expira#ion Date: � Z � � '� <br /> Phone: �SZ �t S f� �-I � S'� Alternate Phone: (, ( Z `-I 3�{ 2 5 SS <br />