Laserfiche WebLink
t <br /> ,. <br /> , ' <br /> ' FOR CITY USE ONLY <br /> �0�` City of Orono Date Received: Permit# <br /> "r P.O.Box 66 <br /> �° � 2750 Kelley Parkway ❑In-House SAC Determination Fo�m Completed <br /> �;.�,; <br /> �j'���=�'. �* Crystal Bay,MN 55323 <br /> �� �'�, µ" o~ 952 249-4600 A roved B If Re uired <br /> 'f��?1�?;�� � ) PP Y� 4 )� <br /> �$axo$ <br /> CITY OF ORONO—SEWER & WATER/ GENERAL PERMIT <br /> (*Note:Some pennits may require approval Uy the Building Official and/or Public Works Department*) <br /> (ALL PERMITS- Mav be subiect to further review and mav not be issucd when the ann�ication 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. Pein-ut cards will <br /> be sent by retuin 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 pemut card is available on the job site. <br /> 5. Urility connection peimits 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 work must be done in accordance with State Code requirements. <br /> 8. 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 Apply) <br /> �Residential(May Require Approval) ❑ Commercial(Approval Required) <br /> ❑ New Connection ❑Additional Connection ❑ Re-Connection ❑ Repairs �.Disconnect <br /> Job Site/ Owner Information: <br /> � �Site Address: .3�� �� ��5�-o U;� <br /> Owner: �,.�,� ��Z-f�.�<� Mailing Address: <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> Contractor: �%('�� l�-r��,��c- Contact Person: � C�, ,�,2 <br /> ��� <br /> Address: _�f��,v �a. ,P�Ipf State License #: <br /> City: �TIGe— Zip:s'.t'3i� Expiration Date: <br /> Phone: ��—�1?�- ��.�7 Alternate Phone: <br /> � <br /> ,� � 3 <br /> �,. . , . . _ . _ . . . � , �A' _ _ i� _ . . � � . <br />