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♦ <br /> FOR CITY USE ONLY n (�r� <br /> Q.U/�/O City of Orono Date Received: _!/ _' � Pemut# �1�/(�V I ( <br /> P.o.Box 66 <br /> /'' i 2750 Kelley Parkway ❑In-House SAC Detercninat�orm Completed <br /> � � Crystal Bay,MN 55323 ��1' �Y�'�' <br /> ..�^,�`��^ (952)249-46U0/Fax(952)249-4616 Approved By(If Required): <br /> 11�� <br /> CITY OF ORONO-SEWER& WATER/GENERAL PERMIT <br /> ("Note:Some petmits may require approval by the Building Off`icial and/or Public Works Department') <br /> (ALL PERMITS- Mav be subiect to further review and mav not be issued when the aoolication is receivedl <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 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�600)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 gant 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 ��(L�o�c,�r,�r �G�.�%L �rl- <br /> Owner: �e�� U � l�v' Mailing Address: /�/� j�Q�i�v,� �,,�,��� <br /> City: �r cL�, Zip: 3�S ��,� <br /> Home Phone: l�fZ- Z Z(�"' �}(�79 Alternate Phone: <br /> Contractor Information: <br /> Contractor: �v �r� - �0O'f�r Contact Person: -��i � � , ,.r <br /> Address: 145.�C� � 7.� A v,-,/fi' State License #: t'C- ��j y'(�L ( <br /> City: Zip: S S-�r��nExpiration Date: � 2/31 � Z o I"� <br /> Phone: ��3-�/5-s`i�a 7 Alternate Phone: <br />