Laserfiche WebLink
, <br /> 1 �' <br />. � <br /> �� , FOR CITY L�F OM,Y- ��//� <br /> ;,,y�-��I�I�-�.. City of Orono Uate Reccived: ��v_t� Permit# ��S' --'v 5G <br /> P.Q Box 66 <br /> �� ; 2750 Kelley Parkway ❑In-I�louse SAC Determination Form Completed �� p�� <br /> �� � t Crystal Bay,MN 5�323 �;,,:`•� <br /> `��,b-`, (952)249-4600/Fax(9�2)2�19-461 G Approved By(If Raquired): � <br /> �,€,��'� . �/1 <br /> I <br /> 'l� �L' � k+� <br /> CI:TY OF ORONO—SEWER & WATER/U:ENERAL PERMIT Z � 1 <br /> (*Note:Some permits rnay rcquire approval by the Building Official and/or Public Works Department*) � �� 1 <br /> (ALL PERVIITS- 11av be subiect ro further review and mAv not be issued when the application is received) <br /> GENERAL INFORMATION <br /> L 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 [N ANY STREET AND DO NOT TAP ANY MAIN without express <br /> approval of t�he 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 notiee required. <br /> TYPE OF PERMIT <br /> Check All That A 1 <br /> [� Residential (May Require Approval) ❑ Commercial (Approval Required) <br /> ,� <br /> �Iew Connection ❑ Additional Connection ❑ Re-Connection ❑ Repairs ❑ Disconnect <br /> ❑ Water���i}�ility Connection For Future Hook-Up to Water <br /> v <br /> Job Site / Owner In� � 'on: <br /> i.` ' , <br /> Site Address: �` � <br /> Owner: t,��l� ��e��, Mailing Address: 1'l� t.7�,C ��� ' <br /> c'�ty: s�. �a.a,r z�p: ��` ,f��l <br /> Home Phone������_�Z� d Alternate Phone: <br /> Contractor Information: <br /> Contractor: � ` Contact Person: t'�"'LL ���� <br /> S <br /> Address: �S�l�� �v�s��l% State License #: ��� ���� ��� <br /> City: Zip: �U�� Expiration Date: � <br /> Phone: ��Z �S tS �'�L Alternate Phone: �� �,�GS ���� <br />