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FOR CITI'USE ONLY <br /> `"` Clt Of�1'Ono Date Received: Pennit# <br /> ��IO¢0���. P.O Box 66 <br /> �� ,;� � 2750 P.elley Parkway ❑In-I�ouse SAC Determinat�on Form Completed <br /> l� ���x�`. �.) Crystal Bay,MN 55323 <br /> r{�3�}yG`/ (952)249-4600 Approved By(If Required): <br /> ���of� <br /> '�,.—_�,- <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- Mav bc subiect to further revicw and mav not be issued when the anplication is received) <br /> GENERAL INFORMATION <br /> 1. You may apply for utiliry 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)far 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 A 1 ) � <br /> �Residential (May Require Approval) � Commercial(Approval Required) <br /> �New Connection ❑ Additional Connection � Re-Connection �Repairs � Disconnect <br /> Job Sife/Owner Information: � <br /> Site Address: � � <br /> Owner:���������'�2'�� Mailing Address: <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> �Contractor Information: � <br /> � ,� �, ��'e�c.� ' , <br /> Contractor: Contact Person: <br /> Address:� � U��C',����ate License #: /�� <br /> � <br /> City: r�(1i�1 � Zi}�����Ekpiration Date: / �- � � G �Y <br /> Phone:��� �Z�� �/ � Alternate Phone: �v l �C%/ � � �� � <br />