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. <br /> �--� FO�SE ONLY �,� ��� �� <br /> ��0�10� Clty Of OCOriO Date Received: Permit# ---��-� �i�i��S <br /> �' '�t P.O.Box 66 , <br /> � � ; 2750 Ketley Parkway In-House SAC Determination Form Completed (, <br /> � �,^ ,�j Crystal Bay,MN 55323 �` <br /> �\'t,�x.�s ` F�j (952)249-4600/Fax(952)249-4616 Approved By(If Required): ��'C�� <br /> �Acs�i��`j <br /> CITY OF ORONO—SEWER& WATER/GENERAL PERMIT <br /> (*Note:Some permits may require approval by the Building Official and/or Public Works Departrnent") <br /> (ALL PERMITS- Mav be subiect to turther review and mav not be issued when the aualicallon is received) <br /> GENERAL INFORMATION <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 retum 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 IN 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 must be inspected before it is covered. Call(952)249-4600,24+hour notice required. <br /> TYPE OF PERMIT <br /> Check All That A pl <br /> (�Residential(May Require Approval) ❑ Commercial(Approval Required), j�� <br /> r�cvi"3 � � <br /> ❑ New Connection ❑Additional Connectionn�e-Connection �Repairs ❑Disconnect <br /> ❑ Water Availability Co tion For Future Hoo - p to Water <br /> Job Site/Owner Information: <br /> Site Address: 29d ���►�tL✓ vR-� <br /> Owner: 7`Itil ,8�`�'2 Mailing Address: <br /> City: d��0 Zip: <br /> Home Phone: Gia. ?a�-a9��3 Alternate Phone: <br /> Contractor Information: <br /> Contractor: t�.S'.�?. �X[A�'.t+��✓���+/L. Contact Person: /,IIkL �d�/1��✓L <br /> Address: Z�iL �,��t�i,�� �f�� State License#: <br /> City: �11�LS Zip: �33 Expiration Date: <br /> Phone: LS� �/�D./3�.f Alternate Phone: lo/� 9/9. y,�y� <br />