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r "" REC��pv�D <br /> C��:�:�� ' ��; ?_O1� <br /> ------------- ------- --- -------� <br /> �- v �� ����:E��',�� -1�y-y//�� <br /> __ <br /> - -- ---------- � <br /> ��.��\ C`tty of C?Yo�o ])ate I:�cai !� � - - f'���niti� _ ��'C � <br /> % ; e.o.R<�x rc CITY OF ORONO �- ------- " ( <br /> �� ;g j ?.75�KeLley Parkway �;ln-fivu;e.S.�ei:E�c�erminatir�n Pm��n t'oc�plet,tt <br /> �,� , -I (rys?a;B•ay.Ni;�>Sz�? <br /> V �'"� ,/•` (95�)249-45t�0/Fax(952)249-461 G •''�{��:rove<?I3y(li Rer.�uir<rc`)' ---- � <br /> CITY �3F URONO-SEVF'ER c& WATF:IEt/(gENE.RA�, PER'�IIT <br /> (*Nate�Some permi±s may reyuire approval hy the Building Of17;;:aE and/ur Pt.blic VJork;Departm�nt*j <br /> �.41,1�:�'k:RNi[TS-_;via_v_E�e s�bqect t�i'urEher retiierr a€�d mav not b�issued when Ehe aupiicatamn ds rereived) <br /> ----- ------------ -- <br /> � GE'tiIER�'�L IN�'OR�1���TIt�N � <br /> -------------------------------------------------------------------_-------------------------- ---------� <br /> i. You may appEy for utility pern:its by niail ar ir�person at the City oft'ices. <br /> 2. Mailed in c�pplicaEior.s are subject to the pastage an�handling iee sh�wn below. Pennit cards u�ill <br /> b�sent by retun�n�ail withi3�2 biRsiness days. <br /> 3. Permits are not valid unt�E,you rece'rve a percnit cartl. <br /> 4. Work m��st not begin anless the permit card is availai�le o��the jc�� site. <br /> S. Utflity cozinec't�on permits may b�isssiec�to licer�sed contracturs onty. <br /> b. Contact the Pubiic'vVorks Depac-tme�lt{95u-24t?-4(�00}for utility stub as-�built locatic�ns. <br /> llU t�"Q7'EXCAV.�,T�IN �"VY STR�E'�'.4i�?I3 DO':V(3T T,4,P.�'VY "vtAIN w°rttta��t express <br /> appravni af the Public Works TS+e��rta�eret. Iss,iarice of a permit dc�es nat grant�his approval. <br /> 7. AI:w€ark 3nust be dune iri acc.or<3ance ivi#�Y Stste Code requir�r�ients. <br /> ti. All work m.ust oe inspected l�efore it is covered. Call(9S2)249-4600,24+�t�o��r�otice reqx�ired. <br /> ------------------------------------------------------------------------------------------------------------ <br /> - ----------- ----- ---------- <br /> i �'YPi; C}E� �'�AR1�1IT i <br /> ; _(�'I�c.ek Al!_1"hat �'���ly_)------------------- ----a <br /> (�Resi�entiai (May Require A�proval} [] C�+�;1js�er�.i�l �A}�proval �eq�iire�) <br /> � Ne•,�C'anr�ection [� Additional Cen���eciion � Re-�Cs�r�naction � Repairs C Uisconnect <br /> L] Wat�r Availabili:y Connectron Fc�r�uture Hook-ll�a to Water <br /> -------------------------� <br /> ----------------------------------------------------------------------- <br /> ; .ic}h �ite i{?rh�ncl�Ij�fui•mati��n: _- - <br /> Site Address: /5 3� �t:h►'l 5 �f" � <br /> Owner: �D i �}'Z- Mailing Addre�s: -�d f ��Ci.V� S OY�KK-W� �SV 1 <br /> ��i_7 i ��'��v•,� <br /> , , i, <br /> c.�ty-: __ _--- �' c�_�__��1 z,�� �_���5 <br /> Han�e Phone: _ _ _ Alten�ate Pl�arae: �� 5 '��f - C�O�� �� <br /> --------------------------------------------------------------------------------------------------- <br /> � �'ilratrac,tct�� Int��-�-��aiii�n� - - --� <br /> ; <br /> �OT'IEi2CtCli': �,,�J It'�/V�—'V��Q I 1'1L �.11IltaC;X�f',�'SUri: � I Y� J`�'vV'�-�[ <br /> :'ld�tress: �I a 3� �-a.�Wl-bYl.�"�/(,l�State Licerise#: <br /> City: G(.ILC�Y�-✓ Zi��S;��� Ex�iratir�n Dat:.: <br /> Phone: ?�'.3 `�Z4�G'3v _ �Iter�rate Pl�oz�e: �_� Z. �(��C.� �'�`Z� <br />