Laserfiche WebLink
' � /, i i. �i - - ,I f/ L - <br /> r'����= � r� ���� ��,,,r-� l,��t f ,•y���� ; / �z% ��1��,;1 �_�-���.,«��< .��;� /�:�� ���-.. <br /> .� <br /> f <br /> FO C��SE ONLY <br /> -1����N�� City of Orono Datc Reccived: Pcrmit# ��n^ �� <br /> P.O.Box 66 <br /> 1 2750 Kellcy Parkway �In-House SAC Determination Form Completed <br /> � � Crystal Bay,MN 55323 �� <br /> `•``�.1 ±'�,,'-� (952)249-4600/Fax(952)249-4616 Approved By(If Required): <br /> n,.,,,,� � zll�Ja� <br /> CITY OF ORONO— SEWER & WATER/GENERAL PERMIT <br /> (�Note:Some permits may require approval by the Building Ot�icial and/or Public Works Departmcnt*) <br /> (ALL PERMITS- Mav be subiect to further review and mav not be issued when the aoulication is received) <br /> GENERAL INFORMATION <br /> l. You may apply for utiLity permits by mail or in person at the City offices. <br /> 2. Mailcd in applications are subject to the postage and handling fee shown below. Permit cards will <br /> bc 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. issuancc 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 l ) <br /> �sidential (May Require Approval) ❑ Commercial(Approval Required) <br /> New Connection ❑Additional Connecrion ❑Re-Connection ❑ Repairs ❑ Disconnect <br /> ❑ Water Availability Connection For Future Hook-Up to Water <br /> Job Site/Owner Information: <br /> Site Address: �t��.7 CS/'P��� { i r� E, /�c�/ <br /> Owner:���`r►-► C�r'tr.� Mailing Address: ��-��--� <br /> City: L��l"anc� t�r1 n/ �i Zip: -� ��y� <br /> Home Phone: ��S�� ���(p �f�Z y Alternate Phone: <br /> Contractor Information: <br /> � r <br /> Contractor: l��tf�� J'c�f/��/.5 Contact Person: �1ik v'�'t1 ��c�r r''f <br /> Address: Z f��l/ L ccr�c/P/',�� /1/r State License #: L--...�t,�S13 <br /> City: i�� Zip:�� Expiration Date: <br /> 5 5;3 7(� <br /> Phone: (�(.� �)/�j �//�— Alternate Phone: <br />