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�' ' �- 1.,.�1� -� ��:� S�w -���,Y, <br /> . <br /> FOR CITY'USE ONLY <br /> O��,�`O City of OrOnO Date Received: Pemut# <br /> "r P.O.Box 66 <br /> �'�r 2750 Kelley Parkway ❑In-House SAC Determination Form Completed , <br /> > � Crystal Bay,MN 55323 <br /> 4. <br /> ����yo� (952)249-4600 Approved By(If Required): <br /> CITY OF ORONO- SEWER& WATER/ GENEItAL PERMIT <br /> (*Note:Some permits may require approval by the Building Official and/or Public Works Department*) <br /> (ALL PERMITS- Mav be subiect to further review and mav not be issued when the uaalication is received) <br /> GENERAL 1NFORMATION <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 rehu-n 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. Urility connection peimits may be issued to licensed contractors only. <br /> 6. Contact the Public Works Lepariment(952-249-4600) for utility stub as-built locarions. <br /> DO NOT EXCAVATE IN ANY STREET AND DO NOT 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 notice required. <br /> ' TYPE OF PERMIT <br /> (Check Al1 That A ly) <br /> �Residential(May Require Approval) ❑ Commercial(Approval Required) <br /> �New Connection ❑ Additional Connection ❑ Re-Connection ❑ Repairs ❑ Disconnect <br /> ''Job Site</ Owner Information; <br /> Site Address: �\�� �� ���/�.��:�� �C���� <br /> Owner:��c\�.vc�..����.�.,i r�.�:��-.�_ Mailing Address: <br /> City: ��Z L l�- Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> � � <br /> Contractor: �1���,,�,��,�v,�•�,�j � �, �Contact Person: �a��c.•�� �.�C.� ��1,I,P� <br /> ,�j � ' � <br /> Address: ��\ �kc�.Zc�c\vst:-,<,-� �c� State License #: �`�`�`�-- Y�i�1 <br /> City: \\1����--�,�,k� Zip:Sr>>`l.S Expiration Date: 1-�- ��-��� <br /> Phone: `����-��1�?� -- `� -� i� Alternate Phone: <br /> ,, J <br /> � <br /> � � � <br /> ��I i � � x , : � � <br /> r�. � � � � � � � r� <br /> � � H �' , � � <br />