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� �� � <br /> } � <br /> �—:,A�` FOR CITY USE ONLY <br /> ,�.-����-�-�+�=�„l C'lty of OI'ono Date Received: Permit# <br /> f �"`�� P.O.Box 66 <br /> � �� 2750 Kelley Parkway ❑In-House SAC Determination Forxn Completed <br /> ,� � ' � Crystal Bay,MN 55323 <br /> ���_' '���'� ^� (952)249-4600/Fa�c(952)249-4616 � Approved By(If Required): <br /> .'`e`��-;'�..:.='�',.� <br /> CITY OF ORONO— SEWER& WATER/ GENERAL PERMIT <br /> (*Note:Some permiu may require approval by the Building Official andlor Public Works Department`) <br /> (ALL PERMITS- Mav be subiect to further review and mac not be issued when the apuGcation is received) <br /> GENERAL 1NFORMATION <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 unril you receive a permit card. <br /> 4. Wark 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 a.�-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: ���� l�Oh��S f�or��{- �c� <br /> Owner: ���l�t rG�1 Mailing Address: <br /> City: � TO/JU Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> 1�t�1�1/hi �c'c� 1��• ContactPerson: HUCl,M u/�TL'r{-S <br /> Contractor: � <br /> Address: I y�/�/i S},�t"crnC,'s h��c/ State Lieense#: I' ��Z� ���y <br /> City: ,�nOl�� Zip5j.3u ExpirationDate: ��! ���a'��5 <br /> Phone: ��3���/�"� ?��0 Alternate Phone: <br />