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. <br /> FOR CITY USE ONLY <br /> 0�` Clty Of Ol'Ono Date Received: Permit# <br /> g' `�' P.O.Box 66 �� �G� <br /> ��; O 27�0 Kelley Parkway ❑In-House SAC Determination Form Completed ' <br /> � ��'���'� � Crystal Bay,MN 55323 � yo27� <br /> ������-�,�..�o` (9�2)249-4600 Approved�By(If Required): � � <br /> �ssso$ ( <br /> � �/ 7�75 <br /> CITY OF ORONO—SEWER& WATER/ GENERAL PERMIT <br /> (*Note:Some permits may require approval by the Buildin�Official and/or Public Works Department*) <br /> (ALL PERMITS- Mav be subiect to fm•ther review and mav not be issued when the apnlication 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. Peinut cards will <br /> be sent by return mail within 2 business days. <br /> 3. Permits are not valid until you receive a pernut card. <br /> 4. Work must not begin unless the peinut 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)far 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 pemut 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 Apply) <br /> �Residential(May Require Approval) ❑ Commercial(Approval Required) <br /> ❑ New Connection ❑Additional Connection ❑ Re-Connection ❑ Repairs ❑ Disconnect <br /> Job Site/ Owner Information: <br /> Site Address: ��`7 /V�v T I "' ���^'� �< <br /> Owner:,M,�tn,� ��� �G G.�S����� `�"�Mailing Address: <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> Contractor: ��5���` � �J Contact Person: �5 d'r�.� C��✓� <br /> Address: K���I �� �"� ) � State License #: ����� <br /> City: Zip:�S3d�Expiration Date: l� � �� -65 <br /> Phone: � ����f 7���/�S 7 Alten�ate Phone: ��`� 1 7y�- �77� <br />