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• p .� <br /> FOR CITY USE ONLY <br /> 0,���`O Clty Of Ol'ono 'Date Received: ' Permit# <br /> `r P.O.Box 66 <br /> '4 2750 Kelley Parkway ❑In-House SAC Determination Form Completed <br /> � � ,.� � Crystal Bay,MN 55323 <br /> o (952)249-4600 Approved By(If�equired): <br /> i°SaesoB� <br /> CITY OF ORONO — SEWER& WATER/ GENERAL 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 application is received) <br /> ' GENER.AL 1NFORMATION ' <br /> 1. You may apply for utility peimits 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 pemut card is available on the job site. <br /> 5. Utility connection permits may be issued to licensed contractors only. <br /> E. Cor.tact the Pub?ic Werl�s TJepz:�mer.t(952-249-46�Q)for urility s*ab zs-built locu�or.s. <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 pernut 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 All That A ly) ' <br /> �Residential(May Require Approval) ❑ Commercial(Approval Required) <br /> �New Connecrion ❑ Additional Connection ❑ Re-Connection ❑Repairs ❑ Disconnect <br /> Job Site`/ Owner Information: <br /> Site Address: /0'2��- �}� �ve.-t�V.�- � �_ <br /> Owne��'-��— �]f c��� Mailing Address: /���� [�,� �J�/�a. <br /> City: VG�UnO Zip: �`j�'j(� <br /> Home Phone: Alternate Phone: <br /> Contractar Information: <br /> Contractor�Oth,,p��c�,-� `}'(U�n�v'� Contact Person:� ��0.+r�o�. <br /> U � <br /> Address:l5pp�`(�fl�ka�•,� c�. State License #: c�J�� �M <br /> City: ��(1tl�pfl�� Zip�j�r Expiration Date: /�"' �J�`"'a� ' <br /> Phone: cJ��-• �— `-�� /� Alternate Phone: <br /> � <br /> {; � F � � <br /> , � � <br /> � � � <br /> �� � � , � ,, � � .� <br /> � � � i r_ <br /> f * i s � i .i i � rs:. I <br /> .� � . � . . . . u , ���.i � .tN l � ��� . <br />