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� . <br /> FOR C T i;,SF.ONI,}, <br /> ��;-,��-�-�����. Clty Of�1'On0 Date Reeeived: Permit# �Q �� ��� <br /> P.O.Box 66 �� <br /> ' 2750 Kelley Parkway ❑In-I Iouse SAC Detennination Form Completed �� <br /> �� r , T; Crystal Bay,MN 55323 <br /> �`rn�.t��, ' (952)249-4600/Fax(952)249-�616 Approved 13y(If Required): <br /> ��:Eti� <br /> CITY OF ORONO— SEWER & WATER/GENERAL PERMIT <br /> (*Note:Some permits may require approval by the[3uilding Officiai and/or Public Works Deparhnent*) <br /> (AI,L PERMITS- Mav be subiect to further review and mav not be issued when the aqplication 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. 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 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. lssuance 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 1 <br /> �esidential(May Require Approval) ❑ Commercial (Approval Required) <br /> ���New Connection ❑Additional Connection ❑ Re-Connection ❑ Repairs ❑ Disconnect <br /> ❑ Water Availability Connection For Future Hook-Up to Water <br /> Job Site / Owner Information: <br /> Site Address: �� � �� � �1���-�� � ����-��- � <br /> Owner: L ' � � V" `���``� �e✓� Mailing Address: <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> __ � <br /> � _�� �� � � <br /> Contractor: ��'�`�L•� �`�' �, c.-., Contact Person: �-�d ��� ��� r <br /> Address: ��,'( (:�_- . i�1�� � State License #: <br /> ;4 <br /> City: ��7'�'�`��� `�� Zip:����Expiration Date: <br /> .-) , __ <br /> � � 1--� y '�� � Alternate Phone: ' <br /> Phone: �� " <br /> `, <br />