Laserfiche WebLink
.�..� `���r. �� <br /> . � <br /> G�' � %'—�"'� TUR CIT1'USE ONLY <br /> ������ City of Orono Dace Rece�vea: %-7�-/(- permit# %L l(c-_C� � (�c/ <br /> ', P.O.Box 66 ' !� <br /> � ; 2750 Kelley Parkway ❑In-House SAC Determination Form Completed �J <br /> �,z� �j Crystal Bay,MN 55323 � _/ <br /> �,\,�A��¢,�.� (952)249-4600/F�(952)249-4616 Approved By(If Required): - � l�� <br /> r -�7� <br /> CITY OF ORONO–SEWER& WATER/GENERAL PERNIIT /�'7�� <br /> (*Note:Some permits may require approval by the Building Official and/or Public Works Department*) <br /> (ALL PERMTTS- Mav be subiect to further review aod mav not be issued whea the auolicallon is received) <br /> GENERAL INFORMATION <br /> 1. You may apply for utility permits by mail or in person at the City of�ices. <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 cazd 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 MAIlV 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+hoar nr„ice required. <br /> TYPE OF PERMIT <br /> (Check All That A l <br /> �Residential(May Require Approval) ❑ Commercial(Approval Required) <br /> l <br /> ❑ New Connection ❑Additional Connection ❑ Re-Connection ❑Repairs isconnect <br /> ❑ Water Availability Connecrion For Future Hook-Up to Wat� <br /> Job Site/Owner Information: <br /> Site Address: .�� C ` «' ' <br /> , <br /> Owner: ��� G(/i���Ct� Mailing Address: / � '�//jp1-�'S �� <br /> ( <br /> City: ����( Y E'�'�1"� Zip: .�����— <br /> � <br /> Home Phone: � Alternate Phone: <br /> Contractor Information: <br /> �//�� �,CG��/�CTii�s� <br /> Contractor: ��(,P'G ��l!' ,�f'J � Contact Person: �r,!'� //'I�� <br /> Address: �y� ��'��i'/� �� �Sta e%i'cen e#: � �gZg��/�� <br /> City: (�'"�r��'�� Zip:�-���xpiration Date: '-�- <br /> Phone: ,��Z�S�Z����L Alternate Phone: �.�Z�yy,b -b'��Z <br />