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� <br /> � i <br /> � FOR CITY USE QNLY � <br /> ����/� Cit;V of Ol'ono Date Recei��ed: Pemitt# <br /> P.O.Box 66 <br /> V\� �750 Kelley Puk�tiay ❑In-House SAC Detercnwat�un Form Completed <br /> �` E ; . Crystat Bay.VfN 553?3 <br /> �; •r'\ (9��)?49-4600 Fax(952)349-�616 Ap�xoved By(If Requveci): <br /> ''`�'' <br /> CITY OF ORONO—SEWER& WATER/GENERAL PERMIT <br /> (`Note:Sonu permits inay requue appro�•al Uy @ie Building Offic�al aiul`or Publ�c Works Depa�trne�u*) <br /> (ALL PERAIITS- �Iav be subicct to further reriew and mat�aot be issued tvben the aaplicatioo is recei�•ed) <br /> GENERAL INFORMATION <br /> ' 1. You may apply for utility pemiits by mail or in person at the City offices. <br /> 2. Mailed 'ui applications�re subject to d�e postage and handling fee shown betow. Pennit cards will <br /> be sent by rehun mail within 2 business days. <br /> 3. Pei•inits are uot valid until you i•eceive x permit cArd. <br /> 4. Work must not begui unless die pennit card is a�-ailable on the job site. <br /> S. Utility comiection pennits may be issued to licensed contractors only. <br /> 6. Contact the Public Works Department(952-249-4600)for utility shib as-built locations. <br /> DO NOT EXCAVATE IN AI�'Y STREET A.\'D DO 1`TOT T�IP A1�Y MAIN wittiout express <br /> approvai of the Public Vb'ockc Depnirtment. Issuance of a permit does not grant this appro��al. <br /> 7. All work nnist be done in accordance with State Code requirements. <br /> 8. All work must be uispected before it is covered. Call(952)249-4600,24+I�our notice required. <br /> TYPE OF PERMIT <br /> Check All That A 1 <br /> [�Residential(May Reqixire Approval) ❑Commercial(Approval Req�iired) <br /> �New Coruiection ❑Additional Coruiection ❑Re-Cotmection ❑Repau•s ❑Discoiuiect <br /> ❑ Water A�-ailaUility Conuection For Furiire Hook-Up to Water <br /> Job Site/Owxier Information: <br /> Site Address: o�(oa7 _ � �Q{�Lk_� <br /> Owner:�OYtQ_ �_ � `d�Q1'S Mailing Address: <br /> City: Zip: <br /> Home Phoue: Alteni�te Phone: <br /> Contractor Iufonnatiou: <br /> Contractor: 1 c�-S Ci.0Y1C,Y'� � Contact Person: 11�� �'�1.. �l�'�'C�6Y� <br /> aa�� �- <br /> Address: q106 t30.(,'Etrn�,�t I-�� State License#: <br /> City: �_IL£. Zip:C'�� Expuation Date: <br /> Phone: �Io3��t���-b�1�� Alteinate P�ione: ��a-��� —2`�Q� <br />