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a <br /> � <br /> FOR CITY USE ONLY <br /> ��,�` Clty Of OI"ono Date Received: , Permit# <br /> "r P.O.Box 66 <br /> ��;;, � 2750 Kelley Park���ay ❑In-House SAC Determination Form Completed <br /> � �Il����� �' Crystal Bay,MN 55323 <br /> �t��,j�w��i;,{o�o~ (952)249-4600 Approved By(If Required): <br /> �'sexo <br /> CITY OF ORONO -S�WER & WATER/ GENERAL PERMIT <br /> (*note:Some permits may require approval by the Building Ofticial and/or Public Works Department*) <br /> (ALL PERMITS- DTav be subicct to(urther review and mav not be issuecl�vhen thc anolication is received) <br /> GENERAL INFORMATION <br /> 1. You may apply for utility pennits by mail or in person at the City offices. <br /> 2. Mailed in applications are subject to the postage and handling fee shown bzlow. Perniit cards will <br /> be sent by rehun mail within 2 busuiess days. <br /> 3. Permits are not valid until you receive a permit card. <br /> 4. Work must not begin unless the pernut card is available on the job site. <br /> 5. Utility coiuiection perniits may be issued to licensed conh�actors only. <br /> 6. Contact the Public Works Department(952-249-4600) for urility shib as-built loeations. <br /> DO NOT EXCAVATE IN ANY STREET AND DO NOT TAP ANY MAIN without express <br /> approvll of the Public��'orks Department. Issuance of a pemut does not grant this approval. <br /> 7. All work must be done in accordance with State Code requirements. <br /> S. 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 ApP1Y) ' <br /> �Residential(May Require Approval) ❑ Commercial(Approval Required) <br /> �] New Connection ❑ Additional Comleerion ❑Re-Connection ❑ Repairs ❑Disconnect <br /> Job Site/ Owner I�lformation: <br /> Site Address: / �PC �i�! c'i � (.�}��'�' �� <br /> Owner: �� Mailing Address: <br /> City: Zip: <br /> Home Phone: Altemate Phone: <br /> Contractor Infonmation: <br /> � <br /> Contractor:lV�(��� .S� � Contact Person: �! �( <br /> Address?�S—�u� �'12..��2 State License #: ����-- <br /> City: ���� �r Zip�S 3`��Expiration Date: � � , -3�` �� <br /> Phone: �� � � �� � ��z- Alternate Phone: � �� ( � �/ �2. y � <br />