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r - w <br /> � � ��ONLY <br /> �D�Q City Of OrnIIo Dste it�ecei�ed: p�� <br /> P.O.Bax 66 <br /> 2750 Kdky ParkwaY O Ip-H�nsc SAC Determinalion F�m Completcd <br /> � �- C:rystal Bay,IvIId 55323 <br /> `" 952 249-4600/Fax 952 2t9-4616 <br /> 1�xESHo4-w <br /> ° ( ) ( ) APP�BY(�'RWuir+edlc <br /> CITY OF ORONO-SEWER&WATER/GENERAL PERMIT <br /> (*Note:Som�pamiu maY*e9uu�e approval by d�e Building Official and/or PubGc Waics D�+) <br /> �e.���$- Mav bc anbi�t m fnrther revie�v�ed�n.v wnr h.�■.�wti..��h..�ae..e.:.._L��._._�. <br /> GfiNERAL INFO�tMATIOI� `. � . <br /> 1. You may apply far utility perniits by ma�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 retum mail within 2 business days. <br /> 3. Permits are not valid nntil yon receive a permit card. <br /> 4. Work must not begin unless the peimit cazd is available on the job site. <br /> S. Utility connection permits may be issu�to licznsed cantractors only. <br /> 6. Comact the Public Works Departiment(952-249-4600j for utility stub as-built locations. <br /> DO NOT EXCAVATE IN ANY STREET AND DO NOT TAP ANY MAIN wlthont ezpress <br /> approval of the Public Works Department. Issuaace of a permit does not grant this approvaL <br /> 7. All work must be done in accordauce with State Code requirements. <br /> 8. All work must be inspected before it is covered. Call(952)249-4600,24+�onr notice required. <br /> TY�E�OF PER�T � <br /> Check All That A: <br /> '�,Residential(May Require Approval) ❑Commercia](Approval Required) <br /> �New Connection ❑Additional Connection ❑R�Cannection ❑Repairs ❑Disconnect <br /> ❑ Water Availability Connection For Fut�u+e Hook-Up to Water <br /> Jca� �3�e l(Jw�e�in�o�atian: <br /> Site Address: 2'� �l o S �o�� (:,�Q 1�� <br /> Owner: �q�-�.-, l��� Mailing Address: . <br /> City: Qra.,o Zip: <br /> Home Phone: Alternate Phone: <br /> Cor�trac�or�formatioa: <br /> Contractor: /��� a A�� S�,f,,: ��5 Contact Person: ��^s ��t 5��,�� <br /> m <br /> Address: C��2_� �s r�s ,4.,� hl� State License#: �°1►� 0 62S y� <br /> City: /�� �a I,�,e� Zip:SS 3 S�Expiration Date: 1 z -3( - /� <br /> Phone: 7 6 3 -Z.B�-�'� �� Alternate Phone: <br />