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. <br /> - . r <br /> FOR CITY LiSE ONLY <br /> ,40,�` City of Ol'Ono Date Received: Permit# <br /> :O `rO' P.O.Box 66 <br /> 2750 Kelley Pazkway ❑In-House SAC Determination Form Completed <br /> � ��?�� Crystal Bay,MN 55323 <br /> ,...*yo��� (952)249-4600 Approved By(If Required): <br /> � �rsxo.... <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 w6eo the aoulica600 is receivedl <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 Departrnent(952-249-4600)for utility stub as-built locations. <br /> DO NOT EXCAVATE IN ANY STREET AND DO NOT TAP ANY MAIN withoat eapress <br /> appmval of t6e 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+6our notice required. <br /> TYPE OF PERMIT <br /> (Check All That A I ) <br /> �Residential(May Require Approval) ❑Commercial(Approval Required) <br /> � New Connection ❑ Additional Connection � Re-Connection [�Repairs Q Disconnect <br /> Job Site/Owner Information: <br /> Site Address: 460 Longlake Road East <br /> Owner: Rolling Hills Construction Mailing Address: 233 Walker Ave. N. <br /> City: Wayzata Zip: 55391 <br /> Home Phone: Alternate Phone: �651) 470-3029 <br /> Contractor Information: <br /> Dave's Constuction Serv�t� �'.��' . Dave Weller <br /> Contractor: ontact Person: <br /> Address: 15700 Juniper Rdg. Dr. State License#: 2003-2516 <br /> Ramsey 55303 none <br /> City: Zip: Expiration Date: <br /> (763)422-9074 (612) 685-6780 <br /> Phone: Alternate Phone: <br />