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Feb.26.2015 12 :28 PM PAGE. 1/ 2 <br /> . , � �� ��1--- �� <br /> 1� �'� f�-�- " <br /> ��� <br /> �' U5E ONLY <br /> ��C�/V�� i'ity of Orono Diite�tv � 1'onnit p C�Q/.} ��-�� <br /> I',O.�ox�>C <br /> 1 � 2750 Kalley Parkway ❑In-f iuuse SAC llclenuuuxtiwi b'cmn(:omplctcd <br /> � '. Cryaa�]Bny.Mt�15�323 <br /> � r`11,v�,� (�5z)za9-46W/F•i�x�952)za9-a61e Apprwex313y(if cquircxl): <br /> � <br /> C[TY UF ORONt)—SEWER& WATER/GENER L PERMiT <br /> ("Nnto:Somc permilw muy reyuin:uppmvtfl fiy the K3uilciing OLY'iciul und/or Pufilic orks Ik:pertmcnt'�) <br /> i�yu d whe th a li v c v ) <br /> GENERAL INFORMATION <br /> 1. You�nay apply frn•utiliry perr�its by maiE or in person at the City offi <br /> 2. Mailed in applications are subject to the postage and handling fee shp beiow. Permit cards will <br /> be se��t by retun�mail withm 2 business days. <br /> 3. permits are��ot valid►�ntil you receive a permit card. <br /> 4. W ork must no�begin unless che portni�card is availablo on the job site <br /> 5 Utility connection permits m8y be is�ued to licensed contractors only, <br /> Ei. C;ontact the Public Works Department(952-249•4600}for utility stub s-built locations. <br /> DU NUT E�(C AVAT�I.N A1VY S�'R�ET ANA DU NOT TAP t1N D1A1N without express <br /> app��oval of the R�blic Works Depa�Kment. Issuanoe of a permit d s not graat this approvAl. <br /> 7. All work must be done in accordance with State Code req�urements. <br /> 8. Al(work must be inspec,�tdd btfore it is covered. CaII(952)249-4640, 4+hour notice�'equired. <br /> TYPE OF PERMiT <br /> Clieck All'T'hat� 1 <br /> itesidentiRl(May Require Approval) []Commercial(Approva Requirecl) <br /> Q New Cqnne�tion ❑Additiona]Connection �e-Connection ❑ pairs ❑Disconnect <br /> ❑ Water Availxbility Connec;t�on FUr FutuCe Hook-U to Water <br /> Job Site/Owner�nforn�ation: <br /> Site Address; `� J�� r'+��! <br /> Owner: _ __ __..._._._._.__..._ Mailing Address: <br /> City: � .. .. 7_,ip: <br /> Home Phone: Alternate Pho�ie: <br /> Contractor Inforrnation; <br /> CUntraCtUr: <br /> ��f(?�_r��.,�.. Contact Person: �'"�r � <br /> Address: �l�� 7Sr`�'� St�te Lic;ense#: <br /> City: �' � Lip:�:.xpiratio���Uate: <br /> Pl�.ox�e: �-�7��1� AlternateFhone: 141�`��'�'�f) <br /> I <br />