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. <br /> FOR CITX USE ONLY <br /> ,1�UNO City of Orono Date Received: S %j Pemtit#k'C��T� � �-L� <br /> P.O.Box 66 <br /> 2750 Kelley Parkway ❑In-House SAC Determination Form Completed. <br /> -=� � .- Crystal Bay,MN 55323 � � /�f C' ��y1 itiE- t� <br /> �� � .` (952)249-4G00/Fa�c(952)249-4616 Approved By(If Required): �' � ^ n^ <br /> �,.,,�,� � r��„�� <br /> � <br /> CITY OF ORONO-SEWER& WATER/GENERAL PERMIT <br /> (*Note:Some permits may require approval by the Building Official and/or Public Works Department*) <br /> (AI L PERMITS- Mav be subiect to further review and mav aot be issued when the aoulication 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 uniess the pertnit 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. 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 /> �esidential(May Require Approval) ❑Commercial(Approval Required) <br /> ,�New Connection ❑Additional Connection ❑Re-Connecrion ❑Repairs ❑Disconnect <br /> � � ❑ Water Availability Connection For Future Hook-Up to Water <br /> Job Site/Owner Information: <br /> Site Address: �� � ►-�"���r ��� <br /> Owner: ��J'�i�`�`�. ��I`���J Mailing Address: ��I� a�l}� C I1� I,I� <br /> ��Ty: f�el�c►�5 Z�p: �s��1,3 <br /> Home Phone: "tJ�" Jc�� -USt��� Alternate Phone: <br /> Contractor Information: <br /> Contractor. I`) ��`���', Contact Person: I�`�� <br /> ����� � � C L)�. <br /> Address: �" � !, State License#: � � I ` �� � <br /> City: ������ Zip:�����Expiration Date: �� � �� ! �6 <br /> Phone: -(,��� -!�U� �)� �� Alternate Phone: <br />