Laserfiche WebLink
, . . . <br /> �� �� <br /> FOR C Y E ONLY <br /> 0,���,0 City of Orono Date Received: � it# dDo g- 8s� <br /> P.O.Box 66 <br /> �„� 2750 Kelley Parkway ❑In-House SAC Determination Form Completed <br /> �� e*Crystal Bay,MN 55323 <br /> N ,:� ��,�- <br /> �� ' � �";�..�o� (952)249-4600 Approved By(If Required): <br /> �gL§gp8 <br /> CITY OF ORONO —SEWER& WATER/ GENERAL PERMIT <br /> (*Note:Some permits may require approval by the Building Official and/or Public Works Department*) <br /> (ALL PERMITS- Mav be subiect to further review and mav not be issued when the aoplication 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. Urility connection permits may be issued to licensed contractors only. <br /> 6. Contact the Public Works Deparhnent(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 pernut does not grant this approval. <br /> 7. All work must be done in accordance with State Code requirements. <br /> 8. All wark must be inspected before it is covered. Call(952)249-4600, 24+hour notice required. <br /> TYPE OF PERMIT <br /> (Check All That Apply) <br /> esidential(May Require Approval) ❑ Commercial(Approval Required) <br /> ❑ New Connection 0'�itional Connection ❑ Re-Connection ❑ Repairs ❑ Disconnect <br /> ❑ Water Availability Connection For Future Hook-Up to Water <br /> Job Site/Owner Information: <br /> Site Address: j�� � ���-�✓��'I �� � ���1-�" ��4� j��9�l1� <br /> Owner: �/�f �iL�_.� ��7�1�C� Mailing Address: ����1�l��' <br /> City: �/ �f ���f' Zip: _�d�� ✓�7 !� <br /> Home Phone: CI�Z �/�'� /�2 2/ Alternate Phone: �S^2 r ���� �3 �� <br /> Contractor Information: � <br /> Contractor: Contact Person: <br /> Address: State License #: <br /> City: Zip: Expiration Date: <br /> Phone: ' Alternate Phone: <br />