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<br /> � .� . � A: i'rx�ClS�oN'Y.�' �
<br /> � ,a�� Clty of Orona �4ui�:t�oeiyed:,� - -O� • ;P'aravu�i ��b 9Ff�
<br /> p.O.Box66 • ,'!. '` :.'. '...,:,..• ' •
<br /> �• � 2750 Kelley Parkway ,'0,�(n-Soqso SAf;�e�aoliai�rorrn CWrtiploro'd '
<br /> � CryBtal�3ay MN 55929 �
<br /> ,,�r �� (952)2491t600 �Appcoved Sy(1#'�9uirul):;� '�� .
<br /> � �''�
<br /> CYTY OF ORONO—SEWER& 'VVATEI�!G�N�RAL PE�m
<br /> ("Hoce;3omc pmni[�m9y rtyu9Tr opproval by tba Huilding Q£Lcial and/ar Publir Works Deparimm��*)
<br /> fA17 1'k"RM1TC- MAv he auhioct tA fur[h�r review and mnv noC{�a iNRuad whrn the opf11i1'arlon ia r�e 'vd �
<br /> �GEI�TERA�,'�'OR�iIATION - � � � � . . • � � � ,�� .. , . ..
<br /> !. You m�.y ap'pl�for uiiliry pennizs by mail or in pe�son at th�Ci'ry oftrcos.
<br /> 3, M�+iled in applictiuons are subjeet to ttte postage as�d h�3zdling fae shown belo�v� Permiti�ard�will
<br /> be sent by retura mdil wi�n 2 bu9iness days.
<br /> 3. �'ermits are not Walid until you receive A perrnic rard.
<br /> 4. W'ork rnu5ti�ot b�gin unless ihe permir eard is avp,i.lubks on the job site,
<br /> 5. UtiliYy couaection perm9,�ramy b�i��uod to licar�s�d eoa�ractors only.
<br /> o. Conrac�the Public Vlroti�s Deparcment(952-249-460o)for un'�ity sn�b as-bui1Y loc�rions.
<br /> DO 1�10T�XCAVATE I1V'Al'�Y STIi��T e1N11 DO NOT TAP ANY lYYAY1�T without express
<br /> approvai oP eho�'ublic R'orlcc nepartment. Tssuance of a pe�mit does not grana this approv�l.
<br /> 7. All work must be danc�rt acaordancc wirh State Cade requirexaenu.
<br /> 8. All wc�r�c musi be inspecced b�fu,re ir�s ooverad. Call(952)Z49-4�00,24+hour notiee.requirc+d.
<br /> , i. .. ;.i,:;.�,,,;, � � . �. � ' ' ' � - ,
<br /> � ,�,' :, � ;�,�"YPL OF PE�C1�
<br /> , .. ,.,:; �,': , �.,.�, , ,
<br /> .�. ,., �,.;,., . ��;�, � (C�eck:All,��ha'c�' �1�) �;.; ,�,.; ,;i: , ;
<br /> r.�
<br /> �ltosidcn�ial(May Requ�ire Appmval) ❑ Commcrcia](rA,pproval Required)
<br /> �New Cm�necrion [,�Additional Connecrion ❑1�-Co�aaection ❑R�pairs ❑biscoanect �
<br /> Tob Sit�J��v�ri����I�o�xiiad�o'b: '. �'� '����"���
<br /> Site Ad�ress: �7� �ro c�n. 1Q�, �
<br /> �W11C'.r: �C i ►� � u I'I�+�_ ��]1T1��L�CITESS: � 7 0 �f0 Gl n_ 1�'�
<br /> CiTy. C��or� , Zip: �535 G
<br /> �rome phone: 9�a �/7 3 16 7 v Altemaee Phone; ���3 7 6 5r / 3 qt5`
<br /> �Coni�c�te�;k�foxma'�i;o�.:� , .;.���:, :_ �.,
<br /> Contra�tor: ��Se T Co2�T. �� Con't�ct Person: f�b �r� ✓�r 17
<br /> .A,ddress: ��"� � � Stato License#: �Gf,l� ��g�
<br /> City: f'YI��CI�e �a:-►L� �fp�� Ex�iration na�a; �— 8�� 4�
<br /> Piicue: 763 4�9 �D��� A1te�nat�Phone: G ia o l y�3 q
<br /> ze�ie 3Jt1d 1SN0�13SNf1S 050T6Lb�9! LB�ZZ 900Z/80/50
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