Laserfiche WebLink
� FOR CITY USE ONLY <br /> ,���, CitV of Orono Date Received: ! -:v �'� Permit# l�C�3`�ll 7 <br /> O.. O P•O.Box 66 <br /> �, � 2750 Kelley Parkway ❑In-House SAC Determination Form Completed <br /> � �������,;� h�* Crystal Bay,MN 55323 <br /> �^i T�n,�.�o (9�2)249-4600 Approved By(If Required): <br /> '�saxo$' � <br /> CITY OF ORONO—SEWER & WATER/ GENERAL PERMIT �5 5� S� <br /> (*Note:Some permits may require approval by t11e Building Official and/or Public Worhs Department*) <br /> (ALL PERMITS- Mav be sublect to further review and mav not be issucd 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 flie postage and handlinQ fee shown below. Permit cards will <br /> be sent by returu mail within 2 business days. � <br /> 3. Permits are not valid until you receive a pernut card. <br /> 4. Work must not begin unless tl�e peinut 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-buiit locations. <br /> DO NOT EXCAVATE IN ANY STREET AND DO NOT TAP ANY MAIN without express <br /> approval of the Public Works Departn�ent. Issuance of a pennit does not grant this approval. <br /> 7. All�vork must be done in accordance with State Code requuements. <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 Apply) <br /> �Residential(May Require Approval) ❑ Commercial(Approval Required) <br /> ❑ New Connection ❑Additional Connection ❑ Re-Connection ❑ Repairs �.Discomlect <br /> Job Site/ Owner Information: <br /> . <br /> Site Address: /:j � J � �d � <br /> Owner: Mailing Address: <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> � �`�'• . <br /> Contractor: ' � / Contact Person: � <br /> Address: �d t ���State License #: ?�Z��� <br /> City: Zip: jS1/f5�xpiration Date: /Z — 3� � d S <br /> Phone: `�`y 7 �y- G i� � Alternate Phone: �/Z - .3�3 -- y�yl� <br />