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EOR CITY USE ONLY <br /> ��� City Of O1'Ono Date Received: Permit# <br /> P.O.Box 6G <br /> ��•, � 2750 Kelley Park�vay ❑In-House SAC Determination Form Completed <br /> � ��j���� �* Crystal Bay,MN 55323 A roved B If Re uired : <br /> �t�� ,����,��o (952)249-4600 AP Y� 4 ) <br /> '�sasa$ <br /> CITY OF ORONO—S�WER & WATER/ GENERAL PERMIT <br /> (*Note Some permits may require approval by the Building OfGcial and(or Public Works Department*) <br /> (ALL PER��IITS- A�faV be subiect to further review and mav not be issued when the annlication is received) <br /> GENERAL INFORMATION <br /> 1. You may apply for utility pennits by mail or in person at the City offices. <br /> 2. Mailed in applications are subject to the postage and handling fee shown below. Pernut cards wiil <br /> be sent by rehuzi mail within 2 busuiess days. <br /> 3. Permits are not valid until you receive a pernut card. <br /> 4. Work must not begin unless the pernut card is available on the job site. <br /> 5. Utility connection permits may be issued to licensed conh�actors only. <br /> 6. Contact the Public Works Department(952-249-4600)for utility shib as-built locations. <br /> DO NOT EXCAVATE IN ANY STREET AND DO NOT TAP ANY MAIN without express <br /> approval of the Public VVorks Department. Issuance of a pemut does not grant this approval. <br /> 7. All work must be done in accordance with State Code requirements. <br /> S. 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 App1Y) ' <br /> �Residential(May Require Approval) ❑ Commercial(Approval Required) <br /> �New Coimection ❑Additional Connection ❑Re-Connection ❑ Repairs ❑Disconnect <br /> Job Site/ Owner Information: <br /> Site Address: i r�f .U�� �c-� P�L���� 12- <br /> Owner: Mailing Address: <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> , <br /> Contract�{Q c� 4'� � Contact Person: �ll� f�/l��C'� <br /> Address: � �Z_�t �.�i��� State License#: � �� <br /> r` � <br /> City: ���is��� Zip.�3T�xpiratioi� Date: � �/ 0 � <br /> i <br /> Phone: � ��__� C� � � Alternate Phoile: 7�� �� � � ��� <br />