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FOR CITY USE ONLY <br /> �`,����,� Clty Of 01'ollo Date Received: Pennit# <br /> �O "rp;, P O Box 66 <br /> i� x, � 2750 F:elley Parkway ❑In-House SAC Determination Form Completed <br /> �,� i�� �-r �i Crystal Bay,MN 55323 <br /> �'x'�r ��G`J (952)249-4600 Approved By(If Required): � <br /> \.��o. <br /> CITY OF ORONO—SEWER& WATER/GENERAL PERMIT <br /> (*Note:Some permits may require approval by thc Building Official and/or Public Works Department*) <br /> (ALL PERMITS- Mav be subiect to further review and mav not be icsued when the aoplication 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. Permit cards will <br /> be sent by return 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 permit card is available on the job site. <br /> 5. Utiliry eonnection permits 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. lssuance 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 A 1 ) <br /> �Residential(May Require Approval) � Commercial(Approval Required) <br /> � New Connection �� Additional Connection � Re-Connection �Repairs "��Disconnect <br /> l <br /> Job Site/Owner Information: <br /> Site Address: � �(�� � Q ���,7� ��� <br /> Owner:�p�( (,a�� c��r�, Mailinb Address: <br /> CitY� Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor Information: � <br /> r <br /> Contractor: �� �,�1��; C� Contact Person: ��('���✓[ �_���� �% <br /> Address G�C�� �� � 15 State License #: ��f�G�1 <br /> Cit}': ��L'�C� Zip:���'YExpiration Date: I�- ��-� � <br /> Phone: <��� �f7a-Y��� Alternate Phone: �d l� �y�- c7� S <br />