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� FOR CITY USE ONLY <br /> �0� CItV Of 01'Ono Date Received: � Pem�it# <br /> O f Q P.O.Box 66 <br /> �,t4r 2750 Kelley Parkway ❑In-House SAC Determination Form Comple�ed <br /> a '!�%`'��=? Crystal Bay,MN 55323 <br /> � �� �''��`a o� 952 249-4600 Approved By(If Required): <br /> `"t`����t?;�rw ( ) <br /> '�sexo$ ---— <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 PEI2(111TS- Mav be subiect to further review and mav not be issued when the aoplication is received) <br /> GENERAL INFORMATION <br /> 1. You may apply for utility pennits 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 rehirn 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 pennit card is available on the job site. <br /> 5. Utility coimection permits may be issued to licensed conh•actors only. <br /> 6. Contact the Public Works Department(952-249-4600) far utility shib 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 pernut does not grant this approval. <br /> 7. All work must be done in accordance with State Code requirements. <br /> 8. All work must be ivspected 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 Comlection ❑Re-Connection ❑ Repairs �Disconnect <br /> Job Site/ Owner Information: <br /> Site Address: � �-5 � C�SC%C� C//��[�C _ <br /> Owner: i��IL ���� Mailing Address: <br /> � City: Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> Contractor: ���l� �- �N�-' Contact Person: -��'1 <br /> ��35� <br /> Address: (��rZ7 ������� � �����7�tate License #: � D�� �7� <br /> � <br /> City: ��4fF�f�L''�l �1� Zip:s�/� Expiration Date: -`'���--�e�d G <br /> Phone: ��� �7U YY�� Alternate Phone: <br />