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� � . <br /> =—�` � FOR CI'1'Y USE ONLY <br /> `�'g— l�l City of Orono Date Receive�i�'j�f�__ Pennit# e�� � <br /> � \ P.O.Box 66 <br /> �� 2750 Kelley Parkway ❑ In-House SAC Detennination F"orm C.ompleted <br /> �y\i �� Crystal Bay,MN 55323 <br /> `.���z'�,�'�/� (952)249-4600 Approved By(I f Required): <br /> . �rs't�ro � <br /> CITY OF ORONO — SEWER& WATER/GENERAL PERMIT <br /> (*Notc Some permits may requirc approval by the Building Official and/or Public Works Department*) <br /> (ALL PERIVIITS- MAv be subiect to further review and mav not be issued when the xuplication is received) <br /> GENERAL INFORMATION ''''' <br /> L 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(952-249-4600)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 Apply) <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: �� �� �,�� � ���'� S�� <br /> Owner: Mailing Address: <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> � <br /> Contractor: ���E;>✓1�S �,v�� Contact Person: � ��S�� �������� <br /> Address: ��`� �•�,�,�� /S State License #: <br /> City: '�C��-r�� � Zip:S"s �(l�Expiration Date: <br /> Phone: �� �_��-( 7�t--�� Alternate Phone: <br />