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Dec 31 09 04: 17p p, l <br /> , <br /> NOK crrr usu UN�..v <br /> Q¢O�O City pf Oton� nato Rcooivcd; u,_,,,,�,,,�_ Pcrmit N <br /> P.0-Aox f;fi <br /> 27.;0 Kelley PnTkwnY ❑Jn-hlw�SNG 1?ctvnt,�nnt+�.�,Porm Complotod <br /> � •�, � C�yetnl Liey.MN 55?23 <br /> � (952)244-Ab(10 Appmved liy(If RequiraJ): <br /> i��.�xo� <br /> C1TY OF ORON()—SEWER& WAT�R/GEIVEIZAL 1'�:RMIT <br /> ('IVolc:Svmc permi�9 moy roquiro appmval by Uvc Iiuilding Olricin]nnd/ur Public Wnrks llcp:u'lmcnl•j <br /> (Ald.1'1i�M�5_JNav_Ae apbicct 1olurihcr r�icw rntl mw�nol he lasnt�l whe b'+onit�IR�n�r�r.elvcA) <br /> GrNL'RAL 1NPORMATJON <br /> 1. You may apply for utitiry permits by mafl�r ln person at thc Ciry o�ccs. <br /> 2. Mailcd �a applic�tions ar�subjcct lo th�postxgc and hr,ndling fcc shown bclow. Pcrmit onrd.,will <br /> be sent lry remrn mail within 2 busines,c days. <br /> 3. Permika are not vnlid until you receive a�permit esrd. <br /> d. Work must not bebin unless 1hc permit crxrd is availablc oa thc job sile_ <br /> 5. Utility connection permit5 mQy be issued to licensed cantrnctors nnly_ <br /> 6. Conlxct the Public Works Departmcnt(952-2A9-4G00)for utilily slub s�-buill locs�tions. <br /> DO NOT EXCAVATE YN ANY STREET ANU DO NOT TA)'ANY MAIN without express <br /> approval of the Public Wurks Dep�rtment, issuancc of a perm;t docs no[firunt this approval. <br /> 7. All work must be done in accorda�ce with SGste Coc1e rcquirements. <br /> 6. AlI woTk must bc inspcctcd bcforc it is covcred. Call(452)249-4600,24�+hour notice required. <br /> rrnE o�.rEnM�r <br /> cncck ni� rnat� i <br /> ❑R.esidenti�l{May Rcquirc Approval) ❑Commcrcial(Approval Roquircd) <br /> ❑New Connection ❑Addi�ional Cormcction �Ro-Connection ❑Repairs ❑Disconnect <br /> Job Sitc!Owncr lnformation: <br /> 1� �; � /� <br /> Site Address: �.>�j�� ,�(,�;�)( �� ;��iJ,��f ���'�:����1 <br /> ( �"� ' � ; �' � �j'1f1�� , � r _� i- t:/��J-e^— <br /> Ownc;r: � �(. Mailing Address: � /> � �l /� i <br /> City: 4-� '�� '' s�' �� ' ►/� Zi /J�� i ' ��� <br /> ,—�T�I � P' �,�_- �. <br /> � -� -� ,..') -.� . <br /> Home Phone: >� � - �.��, -(�� Alternate�bone; <br /> ContracCor lnformation� <br /> Contractor: .i_.yl.�� �C�'/1 l,�'1 r'I'i;�%'�i/���/ �;ontact Person: �C•�L��1 <br /> � J <br /> r --1� � <br /> Address: �;�L �-� 1� ��G�; Stalc�,icense#: �,' ' � <br /> „ � C� <br /> City: (,�;�jL�,L� Li� ��L/Trxpiration Date: <br /> . <br /> ,...� � <br /> t`: � ll , <br /> nhone_ �4:'.�:� LI[� 1 ����� L� Akernate Pl�one:��I'� •��.��c� r���; L�(1 <br />