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�/tv-�2001 12:02pm From-CITY OF ORONO +9522494616 T-259 P.004/005 F-215 <br /> �CREDENTTAL CER'r�CATION APPLICAT'YON <br /> CI'r�Y (1F ORONO � <br /> 2790 Kelly Parkway, P.O. 8ox 66 <br /> . Crysrtal Bs��►, MN 55323 <br /> . phon,e: 249-4600 <br /> . . � � - <br /> , . . . _— , � > <br /> Busmess.l l c r-z �. � ,, � ,�� _ t.,,, ; c �, , Phone: t=�1 ._.<_ ;�'� - �;;1 - . <br /> � (Suafncss and Home) <br /> Address:�- ��` � - <� � � �.��- - - . ' <br /> Ciry•_ `_'�s-�ct.�--�- �» �- �,�,� _ State: ����1 Zap: 4 _�=:��Z.�C <br /> � <br /> Type of License Held: Iv�aster Plum.ber , House Mover Other . <br /> State T,icense No. LxpizationAats <br /> Have you ever had a license revoked? � � =- When � <br /> NOT'E: '�'bc City does not have a specia�bpn�t �azm to use. Proof of Workers Compensation <br /> 3I7SFlrance coverage is required �or all contractors. <br /> Check kind of trade applying�for: � <br /> Septic Contractor. (Required: MPCA Individual Sewage Treatment <br /> � Syscems Y,icense) � . ' � � <br /> House Mover (Required: $2,000 Bond, 10-50-iQ0,000 Insurance) <br /> Mechanical (Required: $2,004 Sond, 10-50-I00,000 �nsurance) <br /> Plumber {ltequired: $;L,000 Bpnd, IO-50-I00,000 Insurance OR <br /> a copy o��the State Plumbing InsuranceBond) <br /> Municipal connections (sewer/water) Yes d�� <br /> � �'ire Sprinkler Ynstallers (Required; $2,000 Bond, 10-50-100,000) <br /> Work shall not commenc� until this application has Ueen approved and required permits ar� <br /> issued, Please indicate any other, persons authorized by you to apply for ��ermits: <br /> �i�lST ✓ f,f1m`-,t� 6/ A' �O� <br /> The undersigned h�reby makes application r.o the City of Orono, Minnesota, for credentia� <br /> certification as indicated above, subjeci to the l:�ws of the State of Minnesota and the Ordinance� <br /> of the City of Orono. A,il applications are subject to a ten (10) day approval periad. ��' <br /> disapproved, written notice will be sent. <br /> � --C� � <br /> Si�nature: ���� � ��c.l%� I?ate• /�� � - <br /> !' � <br />