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2011 - 00162 - water connect
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2605 West Lafayette Rd - 21-117-23-21-0007
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2011 - 00162 - water connect
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Last modified
8/22/2023 4:02:13 PM
Creation date
1/28/2020 1:32:04 PM
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x Address Old
House Number
2605
Street Name
West Lafayette
Street Type
Road
Address
2605 West Lafayette Road
Document Type
Permits/Inspections
PIN
2111723210007
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i _. N. <br /> FICIT USE ONLY <br /> 0,0 A,. City of Orono Date Received: / ff Permit# ii-1.A./�"� <br /> P.O.Box 66 <br /> 2750 Kelley Parkway 0 In-House SAC Determination Form Completed <br /> ijyr Crystal Bay,MN 55323 <br /> fiiµti (952)249-4600 Approved By(If Required): <br /> �t+tseso$ <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 application is received) <br /> GENERAL 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)249-4600, 24+hour notice required. <br /> TYPE OF PERMIT <br /> (Check All That Apply) <br /> Residential(May Require Approval) ❑ Commercial(Approval Required) <br /> Tew Connection ❑Additional Connection ❑Re-Connection 17]Repairs ❑ Disconnect <br /> r <br /> ❑ Water Availability Connection For Future Hook-Up to Water <br /> Job Site/Owner Information: <br /> Site Address: o \OL <br /> L- <br /> 0wneA / ( 8(a, .V 1p ailing Address: 6 1-5 . LL(I yd/i <br /> ,v(___ <br /> City: b (o Yt v Zip: 55 331 <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> Contractor: as/-1-6-44A Contact Person: &1/L CUV1 <br /> Address: State License#: <br /> City: Zip: Expiration Date: <br /> Phone: Alternate Phone: <br />
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