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Ara <br /> USE ONLY <br /> C$0�G City of Orono Date Receive Ara Permit ?al-"- a7 <br /> P.O.Box 66 <br /> 2750 Kelley Parkway [],In-House SAC Determination Form Completed <br /> r Crystal Bay,MN 55323 <br /> (952)249-4600 Approved By(If Required): <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 aoolication is receivedl <br /> GENERAL INFORMATION <br /> 1. You may apply for utility <br /> ty permits by mail or in person <br /> 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)249-4600,24+hour notice required. <br /> TYPE OF PERMIT <br /> Check A11 That Apply) <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: aOO 1 On c, I��l <br /> Owner: Mailing Address: <br /> City: o c D rl D Zip: <br /> Home Phone: 01 L L0 i -7 57 Alternate Phone: <br /> Contractor Information: <br /> Contractor: �Of�- 4 Contact Person: <br /> Address: �5��(� � � State License#: <br /> City: Zip: Expiration Date: <br /> Phone: 70- Alternate Phone: <br />