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2015-00276 - sewer disconnect
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4009 North Shore Drive - 07-117-23-44-0004
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2015-00276 - sewer disconnect
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Last modified
8/22/2023 5:39:48 PM
Creation date
10/25/2017 12:59:49 PM
Metadata
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x Address Old
House Number
4009
Street Name
North Shore
Street Type
Drive
Address
4009 North Shore Dr
Document Type
Permits/Inspections
PIN
0711723440004
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t ' <br /> FOR CITY USE ONLY <br /> Q�I�IO City of Orono nate Received: Permit# <br /> � P.O.Box 66 <br /> 2750 Kelley Parkway ❑In-House SAC Detennination Form Completed <br /> i �f Crystal Bay,MN 55323 <br /> ''�� E� (952)249-4600/F�(952)249-4616 •4pp��BY(��9�)� <br /> kESH�,% <br /> CITY OF ORONO—SEWER&WATER/GENERAL PERNIIT <br /> (*Note:Some permits may requice approval by the Building Official and/or Public Works Department') <br /> (ALL PERMITS- Mav be subiect to farther review aed mav Aot be issoed w6en the sodication 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 cazds 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 pernut cazd 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 ezpress <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 Future Hook-Up to Water <br /> Job Site/Owner Information: <br /> Site Address: ��D `�1 �� � f-� ,,o �o� (�'. <br /> , l , <br /> Owner:�he.c'c .�c,hr� �� Mailing Address: �Q� �UiCt,� �� <br /> � <br /> City: n zip: � 5�?/ <br /> Home Phone: I,� _ ��0 - ��U('� Alternate Phone: <br /> Contractor Information: <br /> %� cznlJ� �n5' cX'�,G `�L�i .�� <br /> Contractor: p� � Contact Person: --�U� <br /> Address: ��7"i� ��D � ��ef State License#: � �1��!3�� <br /> City: �i/cG� Zip���'3ExpirationDate: �02 3� ,� /.`� <br /> Phone: �G 3- y� �- �6� Alternate Phone: <br />
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