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ti <br /> Fd CI'1' 'EONLY��y /}� <br /> , J$-���',, City of Orono Dace tteceiv��t �Perm;t#o�[J f � civ 7�Q <br /> � P.O.Box 66 � f� <br /> 2750 Kelley Pazkway ❑In-Iiau�e SAG Detertnination Form Completed <br /> �f Crystal Bay,MN 55323 <br /> �������j' (952)249-4600/Fax(952)249-4616 t�pproutd By(If Requiredji <br /> CITY OF ORONO—SEWER&WATER/GENERAL PERMIT <br /> (*Note:Some permits may require approval by the Building O�cial and/or Public Works Department') <br /> (ALL PERMITS- Mav be subiect to turther review and mav not be issued when the aoolication is received) <br /> GENERAL�iF'f)RMATIDN <br /> 1. 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. 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 NaT 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 noNce required. <br /> TYPE UF PERMIT <br /> CheckAll'�'hatA' 1 <br /> ❑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!Ow�ner Infarmatic�n: <br /> SltB E�(�dY'eSS: 3425 Shorline Drive <br /> OWriet:sadiq punjani/irfan habib Malllrig Ad�T'eSS: 1337 Mound Trail <br /> City: Centerville Zlp: 55038 <br /> Home Phone: s�z-aso-s�s� Alternate Phone: <br /> Ccantractar Infarrnatian: ` <br /> Meyer Companies,Inc. <br /> COritTSCtOT': DBA Pete's Water 8 Sewer CO11t3Ct Pe1'SOri: Lee Meyer <br /> ACICICeSS: 2316 Jefferson St NE State L1CeriSe#: PC689875 <br /> Cl�: Minneapolis Zjp; 55418 EX]711'1t1017 Date: 12/31l15 <br /> Phone: s�2-a�a-o»� Alternate Phone: s�2-a�a-o»� <br />