Laserfiche WebLink
�� <br /> f � ., <br /> . FOR CITY USE ONLY <br /> f ,i" �' ,, City of Orono Date Received: Permit# <br /> /%�'��''� r.o.BoX 66 <br /> ` ��� �'", 2750 Kelley Parkway [�In-House SAC�t,e.`rmination Form Completed <br /> i �t�'�,� - ��� Crystal Bay,MN 55323 s�C- �c�.""�� ���1p��$Z <br /> � <br /> \�y�o (952)249-4600 Approved By(If Required): <br /> �� <br /> CITY OF ORONO—SEWER & WATER/GENERAL PERMIT <br /> (*Note:Some permits may require approval by the Building 08icial and/or Public Works Department*) <br /> (ALL PERMITS- Mav be subiect to furthcr review and mav not lx issu�d when tLe aonlication is receivedl <br /> GENERAL INFORMATION <br /> 1. You may apply for utility permits by mail or in person at the City o�ces. <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 NOT TAP ANY MAIN without express <br /> approval of t6e Public�Vorks Deparlment. 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 /> T'YPE OF PERMIT <br /> Check All That A 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/Owner Information: <br /> Site Address: a► ��J �Q`� �11� 6 �DYI O <br /> �"ec�-q1 na�cna.1 tn1-5 �FSSoC^I. <br /> Owner: k.�QJY1.� (�2�ff'1�U Mailing Address: 1 yo�a 1 �a l .�c S /�leS•f S �'� ��p <br /> p� P>ox te5aou 3 <br /> City: I .S `��c Zip: �75�1(os <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> Contractor: �,�f 1,(,C���- t-�cw�,Y;;%,E�, ��`'Contact Person: ( ��'► 1/ <br /> Address: I 5cR(.� l�Yti:� ��� State License#: <br /> City: ��CG�i` Zip:55�� Expiration Date: <br /> Phone: � ��'���t--G � I ( Alternate Phone: ���-' -��� -�—i��� <br />