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4 _ i <br /> C uSE ONLY <br /> ¢0 City of Orono Date'Received: Permit# -, a30 <br /> O O P.O.Box 66 <br /> 2750 Kelley Parkway 0 hi=House SAC 'nation Form Completed <br /> w' Crystal Bay,MN 55323 <br /> 'dao 4 (952)249-4600 Approved By(If Requited): <br /> +b <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- May be subject to further review and may not be issued when the anolication is received) <br /> GENERAL INFORMATTON <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 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 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)2494600,24+hour notice required. <br /> TYPE.OF PERMIT, <br /> Check All That Apply) <br /> ❑Residential(May Require Approval) ❑Commercial(Approval Required) <br /> ❑ New Connection ❑Additional Connection 4Re-Connection [:1 Repairs ❑Disconnect <br /> El Water Availability Connection For Future Hook-Up to Water <br /> Job Site/Owner information: <br /> Site Address: / <br /> Owner::,� J,'9 ���1� Mailing Address: <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> Contractor:'�-7XOV4 v Contact Person: <br /> Address: 77> P� State License#: d <br /> City: Zip3 4 4xpiration Date: <br /> Phone-76? 7 '2 � b �7/ `- Alternate Phone: ������ �� <br />