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� Jun 09 14 11:17a Westonka Mechanical 952-472-4961 p.1 <br /> ;;,---:--.; O �[T U O�IL.Y <br /> r�,�^-�''�,�-`e City'of Orono Date Receive� ermit k�_� ��� <br /> ''� f%,• P,O.Box 56 <br /> rt � . �1 <br /> 1 2750 Kelley Parkway ❑In-House SAC De[e in�tion Form CompleUed <br /> ` .\,�, , J Crysrdl Bay,hfi:5323 <br /> �;' •��!�. �� {95'_')Z49-46i}��/Fax(452)249-4616 Approved By(If Required): <br /> �::::;.;;;�:..:!' <br /> CITY dF ORO�TO—SE W'ER& WATER/GENERAL PERMIT <br /> (-Votc.Somc permits may requiro app:oval by the Building Official and/or Public�k'orks Departrnent") <br /> �ALL PGRMITS• A1av be subieet tv furthcr mview and mav not be issucd when the aonlication is reccived) <br /> GENERAL INFORMATION <br /> 1. You may apply for utility perrnits by mail or in person at the City offices. <br /> 2. Mailed in applications are subject to the postage and handling fee shov�m below. Permit cards will <br /> be sent by return mai]within 2 business days. <br /> 3. PerFnits arc 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 connectian permits ma}'be issued to licensed contractots only. <br /> 6, Contact the Public Works Deparhment(952-249-4600)for utility slub as-built locations. <br /> DO NOT EXCAVATE[N AN1'STREET AND DO�OT TAP ANY MAI1Y without express <br /> approval otthe Public V�'orks Department. ]ssuance of a�ermit does not grant this approval. <br /> 7. All.inrk must be done in accordance with State Code requirements. <br /> S. A11�i•ork must be inspected before it is covered. Call(952)249-4600,24+hour notice required. <br /> TYPE OF PERMIT <br /> Check All That A t �) <br /> �esidential(1�4ay Require Approval) ❑Cornmercial(Approval Required) <br /> ❑New Connection �ditional Connection ❑Re-Connection ❑Repairs ❑Disconnect <br /> ❑ Water.Availabitity Connection For Future Hook-Up to ti�Vater <br /> Job Site/Owner Infonnation: <br /> Site Address: ��� ��YJ.�� y �J��l.( � <br /> Owner: Nlai[ing�ddress: <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> Contractor: (�L�L'.S�f�ti //l"�� Contact Person: G � G b� �- <br /> Address: -� ��t �5 State License #: '��I�S��/� <br /> ,— <br /> City: �'�� Zip:���Expiration Date; l� —3/" / � <br /> Phone: ��'—�'�.�� � ��� Alternate Phone: � - <br />