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08/21/13 12:17 OLSONCONSTRUCTION 9524485289 p.02 � <br /> . <br /> S�G �•c,c�7��'^i��'`� � <br /> � z-/y`<o /9�� <br /> ;r::,:..,... FOR CTCY USE OPILY <br /> ���rVr� City of Orono Date Receivocl: Pe�mit tl <br /> P.O.Hcix 66 <br /> 2750 Kelley Parkway ❑Io-Houv�SAC D�.�tenninetion Notm Completed <br /> ' � � , .< Crystnl I3ay,MN 55323 <br /> '�.}r''1 .�'�! (952)249�Ifi00 APProved f3y(Tf Required): <br /> , '�;�`.�,�;,;'. <br /> CITY OF ORONO—SEWER& WATER/GENERAL PERMIT <br /> ("Note:S�mic pccmirs may require approvel by the Building Official nndlor Public Works Departrnent•) <br /> (ALL PEYtMIT5- Msv bc aub�,�ct to turther revie�aod mav not be issaed whea tb,e auQliatiao ia mceived) <br /> GENERAL TNF4RMAT10N <br /> 1. You may apply for utitity permits by mail or in person at the City o�ces. <br /> 2. Mailed in applications are subject to the pastage and handling fee shown below. Permit cards will <br /> be sent by return mail within 2 business days. <br /> 3. Permits are not valid untii you receive a permit card. <br /> 4. Work must not begin unless the permit card is a�ailable on the job site. <br /> 5. Utility connection permits may be issued to lice�sed contractors oniy. <br /> 6. Contact the Public Works Department(452-249-46fl0)for utility stub as-built locations. <br /> DO NOT EXCAVATE IN ANY STREET AND DO NOT TAP ANY MAIN wiihout eapress <br /> apprnval 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}249-4600,7A+hour notice required. <br /> TYPE OF PERMIT <br /> Check All That A 1 <br /> (�Residentia!(May Require Approval) ❑Comme,rcial{Approval Required) <br /> �New Connection ❑Additiona)Connection ❑Re-Connection ❑Repairs ❑Disconnact <br /> � ❑ Water Avaifability Connection For Future Hook-Up to Water <br /> Job Site/Owner Information: <br /> Site Address: 1J'`��� j���1�)1"�1��'�'�' <br /> � <br /> C)wr►er:,� !'11' ��`�.)l.l�E�'�(...�..�. Mailing Address: �`,,�,'��J �.-�,��:�-'�UC� �v� <br /> ���: �..�s�� c�r�t��� Z��: ����.� <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> Contractor: l�l�c�f� cr��,j�'1'1.IC'.�fi'r.tk� Cqntact Person: /'C�?y)C'�.,1� �)���/)I'� <br /> Address: �%`1 t� .��,r„����I�j State License#: �J'7�(,� � _ �{� <br /> City: C_(J� Z Zip;��xpiration Date: <br /> Phone: �;��_C/��/�'-(�/r���1 AlternatePhone: �/c�� „��-1.�.��( � <br />