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t <br /> Cr.rY tM ONLY <br /> P.Osof ox Orono Date Received: //�1 r/�1Pe,mit H R01-7— � 610 5 7 <br /> 66 <br /> 2750 Kelley Parkway O In-House SAC D etemift i/ on Farm Completed <br /> Crystal Bay,MN 55323 <br /> (952)249-4600/Fax(952)249-4616 Approved By(If Required): ✓ _ Lf 1/ C <br /> CITY OF ORONO—SEWER&WATER/GENERAL PERNUT Q <br /> (*Note:Some permits may require approval by the Building Official and/or Public Works Department•) <br /> (ALL PFJ M1TS- Mav be subtest to further review and may not be issued when the aonik tin■is rftdv d) <br /> GE1,,1ERAi,INFORMATION <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 PERBT <br /> Check All That A <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: � , f� <br /> I <br /> OWnevzo 2�e_ S Mailing Address: <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor Formation: <br /> Contractor: t `� Contact Person: <br /> Address: e�-� State License#: 57 S?�/J 0 b <br /> C' <br /> City: 2i�_ Zip Ste' Expiration Date: <br /> Phone: �� 0�2 �1? Alternate Phone: <br />