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. � <br /> � C��3 � <br /> Fox�us�oivi,� <br /> f��NO� Clty Of OCono Date Received: Permit tl �� <br /> `, P.O.Box 66 <br /> �' � 2750 Kelley Parkway ❑In-I�ouse SAC Determination Form Completcd ����'pl'U1 <br /> ,�-f Crystal Bay,MN 55323 �p <br /> \\��S�i o¢,��� (952)249-4600/Fax(952)249-4616 Approved By(1f Required): ^ / "' <br /> CITY OF ORONO—SEWER& WATER/GENERAL PERMIT <br /> (*Note:Some permits may require approval by the Building Official and/or Public Works Departrnent") <br /> (ALL PERMTI'S- Mav be subi�ct to further review and mav not be issued when t6e aoolication is receivedl <br /> GENERAL INFORMATIOl�i <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 retum 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. 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 ANY STREET AND DO NOT TAP ANY MAIN without express <br /> approval of the Public Works Department. Issuance of a pernut 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 PERNI�T' <br /> Check All That A i <br /> �Q 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 Wate <br /> Job Site/Ovvner In�o�ation: <br /> Site Address: � �� �� ��( ���'D C n��h� �� <br /> Owner: Mailing Address: <br /> City: (/�D/�8 ��r� Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> Contractor: ��l.��'k� �k � Contact Person: �G,��+�/� <br /> Address: ��� In/ ��7�ST State License#: L. �,3��� <br /> City: �h � a� Zip:Z5�17 Expiration Date: ���-� <br /> Phone: ��� ,�/� � `� z� Alternate Phone: �S� ���o ��7� <br />