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, FOR CITY USE ONLY <br /> Clty of Orono Date Received: Permit# <br /> O���O P.O.Box66 <br /> 2750 Kelley Parkway ❑In-House SAC Determination Form Completed <br /> � ; "x- �+'' Crystal Bay,MN 55323 <br /> ''� '- '.yc`; (952)249-4600 Approved By(If Required): <br /> ..�C8Hp4�. �: <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 PERMITS- Mav be subiect to further review and mav not be issued when the aaalicatian 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. Utility connection 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. 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 A ly) <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: 2590 Casco Point Road <br /> Owner: On The Level Mailing Address: 2638 Shadow Lane Suite 100 <br /> Chaska 55318 <br /> City: Zip: <br /> Home Phone: Alternate Phone: �952) 368-4663 <br /> Contractor Information: <br /> Final Grade, Inc. Stephanie Fern <br /> Contractor: Contact Person: <br /> Address: 3441 Bluff Drive State License#: 1442 <br /> Jordan 55352 <br /> City: _ Zip: Expiration Date: <br /> (952) 492-5100 <br /> Phone: Alternate Phone: <br />