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I . - � <br /> FOR CITY USE ONLY <br /> j=.:���-�--�-��'� City, of OronO Date Received: Permit# <br /> P.O.Box 66 <br /> � � 2750 F:elley Parkway ❑In-House SAC Determination Form Completed <br /> � Crystal Bay,MN 55323 <br /> �� � �� (952)249-4600/Fax(952)249-4616 Approved By(If Required): <br /> � ' <br /> CITY OF ORONO—SEWER& WATER/ GENERAL PERMIT <br /> (*Note:Some pern�its�nay require approval by the Building Official and/or Public Works Deparhnent*) <br /> (ALL PERMITS- Ma�•be subiect to further review and mav not be issued when the application 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 1 ) <br /> ❑Residential(May Require Approval) ❑ Commercial(Approval Required) <br /> �New Connection ❑Additional Connection [�Re-Connection ❑Repairs ❑Disconnect <br /> ❑ Water Availability Connection For Future Hook-Up to Water <br /> Job Site/Owner Information: <br /> Site Address: ,97��'/�CD � /�4 <br /> Owner: S�IV�1✓� �D�� Mailing Address: <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> Contractor: U.�I7� ��i�;�4th4�f�G /^��� Contact Person: t�i �Od�ie�n'fO <br /> Address: � L� ' �S . State License#: <br /> City: ��N�S Zip: ��� Expiration Date: <br /> Phone: li S�l �S�D- /��� Alternate Phone: �/Z 9�9 7'��f'� <br /> T <br />