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. � <br /> FOR CITY US�ONLY <br /> Cit Of 01'ono Date Received: Pennit# <br /> f�.:�0_,_\, Y <br /> '�' � ..\ > <br /> ,�O O�„ 1 0.Boa t,F <br /> �' ,; �� 2750 I�elle} Parkway ❑In-House SAC Determination Form Compieted <br /> ����d ���� ����� �ry�s�a�B�a���N 55323 Approved By(If Required): � <br /> ���ow,.-: <br /> CITY OF ORONO—SEWER & WATER/GENERAL PERMIT <br /> (*Note:Soine permits may require approval by theBuilding Official and/or Pubiic Works Department*) <br /> (ALL PERMITS- Ma�•be subiect to further review and mav not be iccued 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 w�less 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)far 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 /> Job Site/ Owner Information: <br /> Site Address: � � (� � ������ ��� /l� � <br /> Owner: �I�����ti�' Mailinb Address: <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> Contracto�'.�-�� (� �� �� Contact Person: �� � / <br /> Address:7 7S TC�«-����2 State License #: �/ � � <br /> �-5�v <br /> City: - � Zip. Expiration Date: �� � �� � <br /> Phone: ������J� Alternate Phone: �/ �_ �� J UZ � > <br />