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___ H�oK crr��USL otii.�� <br /> j`�g-�l�I \� Clty Of�COIlO Date Received: � � Permit M � <br /> �' � \ P.O.Box 66 ` <br /> 2750 Kelley Parkwa}° ❑ In-House SAC Detcrmination E�rm Completed � <br /> � � Crystal Bay,MN 5�323 <br /> \y ^ <br /> ��F� _ %� (952)249-4600 � Approved�By(IfRequired): <br /> �?a-f-cito��,� i. . � - � <br /> CITY OF ORONO - SEWER & WATER/ GENERAL PERMIT <br /> (*Note:Some permits may require approval by the Buildina Official and/or Public Works Department*) <br /> (AI.L PERMCCS- Ma��be subiect to further review and mav not be issued when the aonlicatimi is reccived) <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 handlinb 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 wark must be done in accordance with State Code requirements. <br /> 8. All work must be inspected befare it is covered. Call (952)249-4600.24+hour notice required. <br /> TYPE OF PERMIT <br /> (Check All That Apply) <br /> [(,]�P�esidential(May Require Approval) ❑ Commercial(Approva] Required) <br /> ❑ New Connection ❑ Additional Connection ❑ Re-Connection ❑ Repairs ❑ Disconnect <br /> ❑ Water Availability Connection For Future Hook-Up to Water <br /> Job S�ite/ Owner Information: <br /> Site Address: � � � _ ,�� (/Q �d <br /> Owner: �o�-� �.� H�,�y �,�/ Mailing Address: _ j �b' ��c',�✓� /¢r/ <br /> City: �,�a���� � Zip: C�✓r�v G'�� <br /> Home Phone: I`7 p��3� -�(��� Alternate Phone: <br /> Contractor Information: I <br /> Contractor: l.� C � Contact Person: U/�> �/`�,� <br /> � <br /> Address: �0�1>`7 1� /�� State License #: �GDD�-37 (� <br /> �---� <br /> City: � � �. Zip: �1 �/l�xpiration Date: 3-3 � - � � <br /> Phone: � �� '� � -� �� Alternate Phone: � �,� � �� 3 ' / v�.y� <br />