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� �.,rrs 9. �y-�/-!� <br /> �o crr����se a;r�.�� �j' <br /> ���1.�-�t�F`� City of Orono Da�e xeceiced� ,�-1.�'�_lQPemut N Z�l�'� � <br /> � � f>o.��.6� �v <br /> ! �� �� '7�U RcII���P�rk�va� � 0 In-Nousc SAC G�tennination Porm Completed /� _ <br /> �t � Cnstal F3it� Mlv 55323 ' j <br /> � � �� f�)52)2=19 dbtx3!Fax(95'_}2�39-d51� ��� � pproved B�(If Itequireci): , <br /> � <br /> \ �.� �� <br /> 4 / <br /> CITY OF ORONO–SEWER & WATER/GENERAL PERMIT <br /> (*\ote:Some pennns muc require approe�al h�the Building O�iicial andlor Public��orks Derarun4nt*) <br /> (V t PFR�11l�S �lat�tx subiect tu further re��ie��and mac not be ieeued whrn Ihe annlieation is receit�eli) <br /> GENERAL INFORMATIUN � <br /> 1. You ma�apply t<�r utiliry permits b�•mail or in person at tt�e C'ity o�ffices. <br /> 2. �lailed in applications are s�ibjeet to the postage and handling fee shotvn b�low. Permit cards�rill <br /> be sent by return mail wiChin 2 business da}s. <br /> 3. Permits are not valid until you receive a permiC card. <br /> �. ��'ork inust not begin unless tiie permit eard is available on thc job site. <br /> 5, l,'tiliTy�conneetion permits may be issued to licensed contractors onl��. <br /> 6. Contact the Public�'�'orks I)epartment(952-?49-4G001 for utility slub as-built locations. <br /> DO NO"� EXCA�`A"I'E [N A1l'ST'REET AND DO 10T TAP ANY �1A1?�wiihout express <br /> appro��al of the Nublic��'orks Department. lssuance of a permit does not grant this approval. <br /> 7. All���ork must be donc in accordance��ith State Code requirements. <br /> 8. All work must be inspeeted before it is cc�vered. Call(952)2�9-�600.2�+hour�iotice required. <br /> TY['�OF PERMI"t' <br /> Check All That t� I � <br /> ❑ Residential�I�1ay Rec3uire�pprovall �Commercial(�lpproval Required) <br /> �v re�;r��S u�Q�SSi�'► <br /> �New Conneetion ,�Additional Connection ❑ Re-Coiuieetion ❑ Repairs ❑ Disconnect <br /> ❑ \btater Availability°Connectioi� 1=or Future H�ok-Up to�'V�ter <br /> Job Site/Owner Information: <br /> Site Address: 3 S`�� J�o�E���E U�. <br /> Owner: �P�^'- "��.�r c.� ,c Mailing Address: 3 S9� SK,,,Rt,.�,�� o� . <br /> c���: oRoNU z��: ,�s34/ <br /> Hame Phone: .Alternate Phone: <br /> C;ontractor [nformation: <br /> Contractor: +`��us T���� "���:T��s��� Contact Person: �u sT� V���+�s <br /> � PC 6�k33o� <br /> Address: �• °� �O" �' State Licei�se tt: �-��-�— <br /> 1�. 3t t� <br /> City: ��`'`�° Lip:��� Eapiration I7ate: i2�3� � <br /> Phone: �`�t `��-� �1� Alternate Phone: �t 2 �- 55�f - 3 S2� <br />