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Feb 10 16 10:30a Metro General 7634282968 p.1 <br /> tag,cir us�orri.�� <br /> ,1(L�!`/r City of OrOno Datc Received .L 10 Permit# ��� �� '� <br /> `� P.O.Sox 66 <br /> lt 27�0 Kclley Pazicway Q ln-Elousc SAC Dete�minavon Form Complcted <br /> %� � i ; Crystal Bay,M1�1 55323 �pp�Q <br /> �� t95?)249�600/Fax(952)249-�fi!6 Approved By(If Required): 1�U <br /> /�h:.Vi��C�`\ <br /> CiTY OF ORON�—SEWER& �VATER/G�NERAL PERNIIT �C�� <br /> I'�otc:Some permi:s ma}rcquireapp-oval b_r the Building Ottroial and/or Public�1'or;:s Department*) <br /> ALL PFRNti'iS M�v bc cuhiect to further revicw nnd may not 6e issued when thc aa�lication is received) <br /> GENERAL IN�'ORl��tATiOlv <br /> 1. You may apply for utility permits by mail or in person at ihe City o�ces. <br /> 2. Mailed in applications are subject to the postage and handling fee shown belo�v. Permit cards will <br /> be sent by return mail within 2 business da}�s. <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 /> G. Contact the Public w'orks Departmeni(952-249-4600}for utiliry stub as-buiit locations. <br /> ll0 NOT EXCAVATE IN ANY STREET A1�fD DO NOT TAP ANY MAjN wiihout express <br /> approval of the Public Works Department. issuance of a permit does not gra�tt this appro�al. <br /> 7. All�vork must be done in aecordarice with Staie Code reguirements_ <br /> 8. All worlc must be inspected before it is covered. Calf(952)249�600,24+hour notice required. <br /> TYPE OF PERM]T <br /> (Check All That A 1 ) <br /> esidenual (May Require Approval) ❑Commercial(Approval Reqt►ired) <br /> New Conq�etion ❑ Additional Com�ection ❑Re-Connectio�t ❑Repairs ❑ Disconnect <br /> �y 'C <br /> ���� ❑ Watzr Availability Connectiott For Future Hook-Up to Water <br /> Job Site r O�vner Information: <br /> Site Address: O���O ���� ��C�� ' `� <br /> Owner: l f1�� Y '�7 � � Mailing Add�ess: � <br /> C�tv: ��Q Zip: �� � <br /> Home Phone: __ Alternate Phone: <br /> Contractor lnformation: <br /> Contractor: Contact Person: <br /> Address: � State License#: � <br /> Citv: � ip: �a�xpiration llate: ��� <br /> Phone: ��3� '1� 4 3� AlternatePhone: (.QfO�rc��-���'7 <br />