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<br /> `CIT•Y OVORQN 0 APPLICATION FOR UTIY ITY'PERMITS
<br /> Box 66(2750 Ke1 e • `` .,;..r, � EWE' AT R, ,�, F
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<br /> GENERAL"INFO �, � s. 711, ; " A; 4 ,4,',,t,.. ••,-'1. :,
<br /> 1 You may appi 0'91--5 �i°lf,,e;�r/1,ii •l• 11 i. person'at.the Cityyoffices « � 't; .T
<br /> 2 , Mailed nap 11 tZ't 'r �.1ltX'i and h dung fee shown 'elow'Permit cards will be sent by
<br /> return 11 1.': '-'i' �rSAlt i•t• 6ax;i t:( „,,,, ,y,.:.,,,,.
<br /> : 3 rr+ Perm,ro� 'ree , Ili t( ee y� i "t, -kky} if., �'�s.1��,,fy,, !' ,,. r � H.'� g .,
<br /> •4 '- '? W°rkm /.' . tubi •t& �iC . fr 1• Jrt.sti4!! '15 �! '� 1. ') + Ar
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<br /> 5 ., '�� Uhilty conn41,-4.1134-7,11• '� it.k7P1•!.",X. Y '�� •i It: • . • •/� '''- ' +
<br /> 6 4, ` Con• tac�t�le };;� s ie�. X111 1 5 , ocahons .DO NOT
<br /> �,r ExcA yA i-Nii� +iii: w `1 r`0A %i j'"1", ` ; i witbou expres%ti.• oval of the Public
<br /> ' .2;.”,4,.Works ep 1'11 i� - .1-, : p a K;.0e •o' l pproval, x
<br /> 7 All wor mus b '•,lelt .w t` -o'a quire; t ,- n „
<br /> 8 -'air),' Allw.r 1n • ' r i` i i fi=t .,1;11 ' , X932)24* '00¢ ; °1,�
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<br /> Occupancy 1 e , 1 IR C r J ' r 1 rl l 11 e' cial 7�,t„�
<br /> Owner'sName: ' T' . 1 11 1 , ..� _ ,
<br /> Mailing A 1 r s 7�
<br /> Contractor's 1 .� 'ho 1 e 11 be 11.-a �;, is
<br /> Mailing A res, ,, .,- z � e
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<br /> ��* pe S��� ��lii�`C-fit ;11.(-4;01. �. � � � � .�� �� ��r��,� cast iron
<br /> .SAC:Charge( '0' � ' x ,(TD,:i t14 Xb"ir/ 1 � 'k " , •0 1, ta. . .ms unless prepaid
<br /> If otprepazl,• as X4I / �i. 1� � n,ifo
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<br /> :'Municipal: a er 'o1�f f, .!1s ;� r : 1 r, ." Y ` ,`
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<br /> pipe iz 4 1w. copper 1 , other'� , ; 4;
<br /> WATER 1JETER m . p o t C y Hall c j .
<br /> - Water me er�mu ''- ......1 I :o 14 - !e s 11 n 1 4:,,,,,,::::,.••°.
<br /> 2 9 4600) upon
<br /> completion of,me �+ I �,1 Y � q F
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<br /> The undersigned`1 er : ` • • •" ! ' : • Orono''fo' issuance of a-reg'" 'ermit, agrees to do
<br /> `all work m stns a •I c-* 1 . • 1 an 'n ~,a n, ,,
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<br /> C , dan esfof thefCityand the regulations of the State of
<br /> 1VLnnesota,an cern e 1 a .1 �: on•thls� ••lie tl•n are com• ete,true; and correct
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<br /> Signature of ppg •Da e . t
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