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rux CITY USE ONLY <br /> gO O� <br /> City of Orono Date ftoeiasd: perin;t p <br /> ` 2750 Kdley Parkway ❑In-Hem SAC Detumbwtion Form C <br /> omphftd <br /> s Crystal Bay,MN 55323 <br /> a� (952)249-4600/Fax(952)249-4616 Approved By¢f Requft"! <br /> xESHO <br /> CITY OF ORONO-SEWER&WATER/GENERAL PERMIT <br /> (•NOW some P=M may mlwm gpovA by ft Building Offmal and/or Public works Dept•) <br /> (ALL - May be sn6rwM to Mrtber M t!!w and Ma Not be imsed wben the apaliesdonis__ <br /> CdMM <br /> GENERAL WFORMAnON <br /> I. You may apply for utility permits by mail or m 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 earl. <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)249-4600,24+hour notice required, <br /> 'l'WE OF PERW <br /> Cheek All That Apply) <br /> TfResidential(May Require Approval) ❑Commercial(Approval Required) <br /> ox*w�eti®n ❑Additional Connection ZRe-Conn�ec;tio�2n ❑Repairs ❑Disconnect <br /> ❑ Water Availability Conn ok-Up to Water <br /> Job She/Owner Wormation: <br /> Site Address: 780 72WeoAih9 <br /> Owner: Mailing Address: <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor Information.- <br /> Contractor: <br /> nformation:Contractor: S,/jI, &k49?*,v4 IW4 Contact Person: <br /> Address: 2,?4 S A• State License M <br /> City: •NQS Zip:$Z?3 Expiration Date: <br /> Phone: �rS'� yBQ./3S5" Alternate Phone: <br />