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� „�,. . �1 '� <br /> FO�USE ONLY <br /> ' �aNQ` Clty Of�COnO Date Received:� Permit# a�0/r7_ �p <br /> P.O.Box G6 <br /> 6\, 2750 Kelley Parkway ❑In-House SAC Determination Fortn Completed <br /> � � + � Crystal Bay,MV 55323 <br /> .��F����� (95'_)249�600/Fax(952)249-4616 Approved By(If Required): <br /> __., - <br /> CITY OF ORONO—SEWER & WATER/ GENERAL PERMIT �/'����`{�� � <br /> (*Note:Some permits may require approval by the Building Official and/or Public Work�Department"`j <br /> (ALL PER�iITS- blav be subiect to further review and mav not be issued when the application is receivedl <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 rehirn 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 connecrion 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 1 ) <br /> ❑Residential(May Require Approval) ❑Commercial(Approval Required) <br /> � New Connection ❑Additional Connection ❑ Re-Connection ❑ Repairs � Disconnect <br /> [� Water Availability Connection For Fuh�re Hook-Up to Water <br /> Job Site/Owner Information: <br /> Site Address: 347��ric Ave Orono, MN 55319 <br /> Owner: Joshua/Markum Builders, Inc. Mailing Address: <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> Contractor: Joshua/Markum Builders. Inc. Contact Person: Mark Olson <br /> Address: 7867 Eastwood Road State License #: BC631542 <br /> City: Mounds View Zip: 55112 Expiration Date: 03/31/2018 <br /> Phone: 621-998-7818 Alternate Phone: 612-940-0041 (Cor� <br />