Laserfiche WebLink
. <br /> � ����� y Fox crt-Y u��oivL� <br /> � Cit of Ol'oIIo Date Received: ;��,�'um�tll � 1 �� � <br /> � � \`• P.O.Box 66 <br /> � ; 2750 Kelley Parkway ❑In-Hoase SAC Determinadon Form Completed <br /> ,� ' ' ,�-�! Crystal Bay,MN 55323 9 n <br /> �\'�1 . �� (952)249-4600/Fa�c(952)249-4616 Approved By(I�Required): -�rC rd� Z����D Y <br /> \'�c�SH�4'� . _ _ . ''�— <br /> ���7d�,J <br /> CITY OF ORONO-SEWER& WATER/GENERAL PERNIIT ���//� <br /> (*Note:Some permits may require approval by the Building Official and/or Public Works Departrnent') <br /> (ALL PERMTI'S- Mav be subiect to furt6er review and mav not be issued wheo the aoolicallon is receivedl <br /> GBNERAL INFORMATION <br /> 1. You may apply for utility permits by mail or in person at the City offices. <br /> 2. Mailed in applications aze 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 pernut card is available on the job site. <br /> 5. Urility 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 ANI'STREET AND DO NOT TAP ANY MAIN without ezpress <br /> approval of t6e 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 i <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 ir�onnation: <br /> � ��� �L' ��G � �� <br /> Site Address: � - � — � <br /> � • . <br /> , <br /> Owner: �f�'� ' �� �'��= ��"�%� � � Mailing Address: <br /> � City: Zip: <br /> Home Phone: �/Z�1��/-y�7 7� Alternate Phone: <br /> Contractar Information: <br /> � �'._�, , f %' , � �A / !Z / <br /> Contractor: � - � - `�ontact Person: �� l �?''�� <br /> , ; � <br /> Address: ��I�C���`����'t���G� State License#: <br /> � ��� 1�J4�� 'S 1 <br /> City: �( ip: � �� Expiration Date: <br /> Phone: �I 7-y�7 �`� Alternate Phone: <br />