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� <br /> FOR CITY USE ONLY <br /> ,��� Clty of OrOnO Date Received: Permit# <br /> O Y � P.O.Box 66 <br /> a;„;.,,,,� 2750 Kelley Parkway ❑In-House SACDeterniination Form Completed <br /> � ��j�?��r;>'_ � Crystal Bay,MN 55323 <br /> � �'',(����..�o'' (952)249-4600 Approved By(If Required): <br /> ���o$ <br /> CITY OF ORONO- SEWER& WATER/ GENERAL PERMIT <br /> (*Note:Some permits may require approval by tl�e Building Official and/or Public Works Department*) <br /> (ALL PERMITS- Mav be subiect to further review and mav not be issued when the aonlication is received) <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. Pernut cards will <br /> be sent by reiuin 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 peinut 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 locarions. <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 pernut 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 /> TYPE OF PERMIT <br /> (Check All That Ap ly) <br /> �.�Zesidential(May Require Approval) ❑ Commercial(Approval Required) <br /> �/ � <br /> ❑New Connection ❑ Additional Connection ❑ Re-Connection V��pairs ❑ Disconnect <br /> Job Site/ Owner Information: <br /> Site Address: ���l�,s ��4��/��'� � ,� � �/2� ,�t <br /> Owner: W% Z L p%C�a 1J Mailing Address: ��f'�2 <br /> City: C�i20 7-� Zip: <br /> Home Phone: � ��-'�6S-��ll/ Alternate Phone: <br /> Contractor Information: <br /> Contractor: . j X���u m•�i �ntact Person: ��G��%- <br /> Address: �� � ��/U �ate License #: <br /> City: �'�b K�tJ7 Zip�byExpiration Date: <br /> Phone: �(,� ^���"�3c�� Alternate Phone: �S;�--3��C= -cr-�-/,y <br /> ;� <br /> a <br /> ;i <br /> , � ; � <br /> F � � <br /> 1 �I J� � �. ,j I � y � <br /> i � f <br /> ; �: , � �� ; t � �... I� � y ` � �,� <br /> ���+ Il z b <br /> . . , . . , �! , .. ,`� fl� .� . Y .�. ... .k' �� (�`�' � .. . . I.i. ., �., ,,.� � o .,i. .�. �y�,� � ,,... . <br />