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FOR CITY USE ONLY <br /> �',�Q��� City of Orono Date Received: Permit# � � <br /> /� ��, P.O.Box 66 ��%"� <br /> � �; �� 2750 Kelley Parkway ❑In-House SAC Determmat�on Form Completed ,� V <br /> �i��'1� �����+i��b`� (52)2 9a46MN 55323 <br /> l, <br /> / Approved By(If Required): (---) �j' <br /> .'��o�/,' f � j�i/ <br /> ' CITY OF ORONO–SEWER& WATER/GENERAL PERMIT � � � <br /> � � <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 bc issued when the aan�ication is received) ��� <br /> GENERAL INFORMATION � <br /> l. 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. Al(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 /> Job Site/Owner Information: <br /> Site Address: �/,S��f LCJvh�'S �/`� �� <br /> Owner: �G l�0�.4_� Mailing Address: <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor Infor�nation: � � <br /> Contractor: �%��-�^�—� �'���'�-� Contact Person: (/''��«-� � �� <br /> Address: `��3� � State License #: � �U f Z <br /> City: 6� ���✓ Zip: S3��xpiration Date: <br /> Phone: 6��- ,3�� �1��� Alternate Phone: �SoZ `fY� �Sv�y <br />