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. <br /> . <br /> - FOR CITY USE ONLY - / � ��� ' / <br /> /��.�l�l��, City Of 01'ollo Date Received: Pertnit# L�i� <br /> P.O.Box 66 <br /> j, y�� ! 2750 Kelley Parkway ❑In-House SAC Determination Form Completed <br /> ' �ti � t' Crystal Bay,MN 55323 <br /> �.'`.��,�,,�(����;" (952)249-4600/Fax(952)249-4616 Approved By(If Required): <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 be subiect ro further review and mav not be issued when the apalication 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 wark must be done in accardance with State Code requirements. <br /> 8. All wark 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 /> ❑ New Connection ❑Additional Connection ❑ Re-Connection ❑ Repairs ❑ Disconnect <br /> ❑ Water Availability Connection For Future Hook-Up to Water <br /> Job Site /Owner Information: <br /> Site Address: �� � � ���-'`� � . I�� <br /> Owner: Mailing Address: <br /> City: G� ��-l�� Zip: <br /> Home Phone: Alternate Phone: <br /> Contractar Information: <br /> Contractor: � �` r �� � -S Contact Person: �� �� ����— <br /> Address: G �`� � � '�� State License #: <br /> City: Zip:��Y-���Expiration Date: <br /> Phone: `�L� �^3G�'`� �t� Alternate Phone: <br />