Laserfiche WebLink
;----------------------__--_-.------------- ------------------ <br /> __ --- .. <br /> ; FOR CITY iTSk:O;tiLY <br /> �t^-����'� Clty of OroDo ; Dace ReceReed. Pem�a�a <br /> �"�4, . """"_"__'_' �"_"__. <br /> ; PA Box 66 i <br /> ;,�� � ?7�0 I�e1:ev Park�cay � ❑Iu-House 5AC Iktemiusatzon F�nn Campleted <br /> , -/ C`r�•sta;Bay.\�FN 5�3?3 � <br /> "' � �'"' , ! (4i?)2�9-�60U Fax(9521_49-�1616 } Apgrosed Hy(IfRequired): <br /> �`=__.�. <br /> CITY C1F OR011O—SEWE_R& WA�TER/GF.NERAL PERMIT <br /> ('�iote 5ufiie peimus a�ai ttquut apgra�'al by the Buildin�Oeficiel anc3ior Pubhc�Vorks Uepa�tment') <br /> (�LL PER�tITS- �Iay be seebicrt tn furiber re�iew�and mat�not be usued n hep the aoulication is recei�•ed) <br /> — - --- -- - - - - <br /> GEI�TERAL INFORMATION <br /> l__�,_�_.___ ...__._�___�__«..�__�__..._�__._..____.r___________.�.__________.._______�...__�._._____..._____`__.._.._.��_ <br /> 1. You tnay appl��for utility pe�n�its by n��il or in person at tE1e City o�ces. <br /> 2. ?�Iailed i�a application�are sithject to the postase a�y�haitdluig iee show-n belo�t. Per�nit cards�ill <br /> be sent by reham niail within Z business days. <br /> 3. Pei•mits ai•e not�•atid unti!vuu receive�pet7uit card. <br /> 4. �.�'�rlc ir.�.st not heg:�a e�iiess t?ie pennir esa•�is a�:ai;a�l�c��itze jab s:te. <br /> 5. Utitity casuiectio�3 pennits may be issued to licensed contractors csnl��.. <br /> 6. Co��tact�l�e Public Works D��airtinei�t{952-?49-4b00)for iitility st�ih as-b��ilt locations. <br /> I}O 1�OT EXCAVATE L�i A1�Y STItEET�lvD DO NOT T�,P�Y MAIti«ithout express <br /> Ap�ro��R!of tIte Pnblic R'orks Depat°tment. Isst�a�ice of a pet�nit does not gF�ant this approti-a1. <br /> '. All�•ork mYxst be dane in a.cordance u,�ith State Cbde requuements. <br /> 8, Ail���ork mtist be uispected beiore it is co�=ered. Call(9.52)249-4600.24�}IOU2'llOtICP I'?(jU1CP(I. <br /> - �--..__.__—._.�� .__------------------------------------------------------------.___.___-----.............------- <br /> TYPE OF PERMIT <br /> -----�Cl�eck_�',.il_Tiiat_AP��.---�._.._.�. <br /> [Z�f Residential(I�4ay Rec�tiire Appi�o��ai'} ❑ Commercial(t�p�ro�al Kequired) <br /> (�Ne���Ccant�eciion ❑Additional Connection �]Re-Coruiectiozt ❑Repairs ❑Discoimect <br /> ❑ Water A�>ailat�ility Connection For Future Hook-Up to Water . <br /> J�b Site/O�.vuer•Information: � <br /> Site Address: � (v% U CC�-�v�1 1'1 {' �y� <br /> (h�Zier: Z 1 V r 7� �� � �� �1��11Zu vi M�tiling Address: _( f�S S?,��-�v`� I�c� <br /> City: y v�l[�C.Y�rr•. 7ig: 5 S 3`-�-U. ._._ <br /> Home Phoiie: Altetnate Phone: <br /> Contx-actor I�iforiiYatiot�: i <br /> Contz�actar: �S S`�.LL';,u� C� l�� Contact Person: J C�.(�t,<il S ���2'�"' <br /> . Adciress: � IO�U �C'u.lMOr���vQ�,�State License�: <br /> City: U}l/ Zip:`)73�{� Expi�-ation Date: <br /> Phone: �7(,:3 -`fZ��C'S i.� �1telY;ate F�zotie: <br />