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wy � • <br /> .. �OR CITY U��.ONLY <br /> ���N��\ City of Ol'ono Date Received: Per�it# <br /> ; P.O.Boz 66 <br /> i. j 2750 Ke(ley Parkway ❑In-House SAC Determinallon Form Comphted <br /> � ,�-� Crystal Bay,MN 55323 <br /> `���is�`�o�-jf (952)249-4600/Fax(952)249-4616 Approved By(1�'Required): <br /> CITY OF ORONO—SEWER&WATER/GENERAL PERMIT <br /> (*Note:Some permits may require approval by the Building Official and/or Public Works Deparfiment") <br /> (ALL PERMTI'S- Mav be subiect to further review and mav not be issued when t6e aoolication is receivedl <br /> GENERAL INFORMATIOI� <br /> 1. You may apply for urility 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. Urility 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 IIV ANY STREET AND DO NOT TAP ANY MAIN without ezpress <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 /> TYP�OF PERMIT <br /> Check All That A i <br /> �Residential(May Require Approval) ❑ Commercial(Approval Required) <br /> ❑ New Connection ❑Additional Connection ❑ Re-Connection ❑Repairs ❑Disconnect <br /> ❑ Water Availability Connecrion For Future Hook-Up to Water <br /> Job Site/Ovvner irs#'ormation: <br /> Site Address: v2 7 I o f<c L�L�j �/�E <br /> Owner: P�;�� ���,� i�'�ti_-2 Mailing Address: o�7 I� � � <br /> c��: ��-�-.��-� z�p: s s 3 3 �) <br /> Home Phone: S�c--� �LP��� .5�Io�� Alternate Phone: <br /> Contrac�or Information: <br /> Contractor: ���-tv � �c��-�P�' Contact Person: V'� � � f'� <br /> Address: �`�5�ti ���/�,��' 1v� State License#: Pl�l �� �1 � � <br /> City: � Zip: �S�`��Expiration Date: ��1 � "o <br /> Phone: 7�3 "����'a 1�� Alternate Phone: 7(v3������17�, P� .� aa���y <br />