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. <br />: <br />� - FOR CITY:USE ONLY <br /> ���0 Clty Of OPOno Date Received . ; Permit# ` , <br /> P.O.Box 6G � <br /> ��� 2750 Kelley Parkway ❑In-House SAC Determination Form Completed <br /> a� � > „�.� �* Crystal Bay,MN 55323 A roved B If Re uired <br /> ��g ��,''r�o c (952)249-4G00 PP Y� 9 )� . <br /> t'�RasRo�'� <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 Niav be subiect to further review�nd mav not be issued�vhen thc annlication is received) <br /> GENERAL INFORIVIATION <br /> 1. You may apply for utility pennits by mail or in person at the City offices. <br /> 2. Mailed in applications are subject to the postage and handling fee shown below. Pernut cards will <br /> be sent by rehirn mail witl�in 2 business days. <br /> 3. Perrruts are not valid until you receive a permit card. <br /> 4. Work must not begin unless the pei�ut card is available on the job site. <br /> 5. Utility connection pernvts may be issued to licensed contractors only. <br /> 6. Contact the Public Works Department(952-249-4600)for urility stub as-built locations. <br /> DO NOT EXCAVATE Il�`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 inust be inspected before it is covered. Call(952)249-4600,24+hour notice required. <br /> TYPE OF PERIVIIT <br /> (Gheck All That A '"`iY) <br /> ❑Residential(May Require Approval) ❑ Commercial(Approval Required) <br /> � New Connecrion ❑Additional Connection ❑Re-Connection ❑Repairs ❑Disconnect <br /> Job Site/ Owner Information: ' <br /> Site Address: �a �,c ,� � i�� <br /> Owner:���� .-�- ��� Mailing Address: �d � �������2 <br /> City: �� ;2�/�- � Zip: �S�S-� <br /> Home Phone: ��� G� 7� � 7��� Altemate Phone: <br /> Contractor Informatioii: <br /> �^ <br /> Contractor:�� ��/� ontact Person: �_ <br /> Address: ���� �/��. �' State License#: �`�� � <br /> City: Zip:�� Expiration Date: � �� �/ ' o `c- <br /> Phone: 7C 3 f� 7 > ��G�`� Alternate Phone: ��/Z -`�/�-`�f G j <br />