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� . � <br /> � R ������� 8`.� <br /> ,,�'��1C�t�t�°� Cit of Orono Date Recei "' Pcnnit�__�: <br /> � Y <br /> '; P.O.Box 66 <br /> , 2750 Kelley Parkway ❑In-House SAC Determination Form Cckmpleteci <br /> '+�� � ' Crystal Bay,MN 55323 <br /> ��,��,.},/�% +%� 952 249-4600/Fax/952 249-4616 Approved By��(If Required); <br /> 1'�t�1tiHC) 4 � � \ � <br /> CITY OF ORONO—SEWER& WATER/GENERAL PERMIT <br /> (*Note:Some permits may require approval by the Building Official and/or Public Works Department*) <br /> (ALL PERMITS- Mav be subiect to Further review and mav not be issued when the aaolication is received) <br /> GE�TERAL TNF�RMATI(Ji� . <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 work must be inspected before it is covered. Call(952)249-4600,24+hour notice required. <br /> ' T'"YPE UF P'ERMIT ,'. <br /> ' Check,�,Yr Th�t A 1 ' <br /> �esidential(May Require Approval) ❑Commercial(Approval Required) <br /> �Iew Connection ❑Additional Connection ❑Re-Connection ❑Repairs ❑Disconnect <br /> ❑ Water Availability Connection For Future Hook-Up to Water <br /> Job Site/Own�r Ir�formatian: ' <br /> Site Address: �6� ��►�,� (�OL-� � <br /> �� <br /> Owner: , !" ?�,,�� Mailing Address: �d 13� �$��) <br /> City: ��'. ��� Zip: (�'��d � <br /> Home Phone:��,;�,�i�� �`�l� Alternate Phone: <br /> 'Con�ractor�nformatifln; ; <br /> � ` — <br /> Contractor: S cc.,E �l� �-s Contact Person: �i�Lc. <br /> � <br /> Address: ���,� Z7C�� J✓G--/ State License #: 1' l.�� 7�y�v <br /> City: � Zip:�� Expiration Date: �Z <br /> Phone: ��2��� 7�� Alternate Phone: �Z ��6 �l� <br />