Laserfiche WebLink
� . � � <br /> � � <br /> FOR CIT USE ONLY <br /> ,���/�/�-, City of Orono Date Received: �Perniit# .�L/ i'G ✓Z zj� <br /> P O. Box 66 l <br /> �' 27�0 Kelley Parkway ❑ In-House SAC Detefmination Form Comple[ed <br /> , i , , Crystal Bay,MN 55323 <br /> '�,� Y�!�t�= (9�2)249-4600/Fax(952)249-4616 Approved By(If Required): <br /> .tiii., <br /> CITY OF ORONO - SEWER & WATER / GENERAL PERMIT <br /> (*Note:Some pennits may require approval by the Building Of�ficial and/or Public Works Department*) <br /> (ALL PERi�II"I'S- Mav be subiect to further review and mav not be issued when the application is received) <br /> GENERAL INFORMATION <br /> I. You may apply for utility pennits by mai(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 /> � <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: ��V S /�`�"`��`'��le �� � <br /> Owner: �G'/,� ��`�`-" "'� Mailing Address: <br /> City: Zip: <br /> Home Phone: �� L �L s ,�9S� Alternate Phone: <br /> Contractar Information: <br /> ,�) <br /> Contractor: ��f u�5�� S�"� � �`�ontact Person: / �' y <br /> •- —�—� <br /> Address: �° ��h 2 y 7 State License #: /`�� �6�� �� <br /> City: ��"� �'�'' Zip:553�7 Expiration Date: / � �`/ <br /> Phone: � �L 7 S �- ��`�g Alternate Phone: � <br />