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. � . � <br /> �� 5; �� <br /> - FOR CITY USE ONLY ,` �S-s/ <br /> �;y��-4-}�,`�'� City of Orono Date Received: Permit# ��Z— <br /> r <br /> s '` P.O.Box 66 <br /> �' �� � 2750 I�elley Parkway ❑In-House SAC Determination Form Cotnpleted <br /> ��� � �-' Crystal Bay,MN 55323 <br /> �' '� '��'�. � (952)249-4600/Fax(9521249-4616 Approved By(If Required): <br /> ``_.✓ , <br /> CITY OF ORONO– SEWER& WATER/GENERAL PERMIT <br /> (*NoCe:Some permits may require approval by the Building Official and/or Public Works Department*) <br /> (ALL PERMITS- Mac be subiect to further revieH�and mav not be issued when the app6cation is reeeived) <br /> GENERAL INFORMATION <br /> 1. You may apply for utility permits by mail 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 wark must be inspected before it is covered. Call (952)249-4600,24+hour notice required. <br /> TYPE OF PERMIT <br /> (Check All That A 1 ) <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 Information: <br /> Site Address: ��L�L� �E��i'�,a'i(.,C �-c�Zf�—�- <br /> Owner: li �7e%`/� Mailinb Address: <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> �� <br /> Contractor: �����1���� ��If �� C Contact Person: ��/�-j��� ������� <br /> Address: ��/7/L� ll�����L� State License#: �� �7�g�� <br /> City: ��1� ('�.�G��Zip:����jExpiration Date: IZ� ��/ <br /> Phone: 7�7��ta`[ �� Alternate Phone: <br />