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Oct-25-2005 03:53pm From-CITY OF ORONO +9522494616 T-T06 P.001/001 F-889 <br /> � FOR.f.�TY USE O1�Fl.'Y , . <br /> R,eCci've�tl: � .:Pei'tzfiuil,,�—_ <br /> City OtOrOA� Qa�. ; . ` •�_ .I„ <br /> D4O�� 27OSOKaIIeyParicWaY �'It►'�IoweS�C•'�tterniinatioo'Ptlrm•Com�lc[ed:• . <br /> t . Crystal Bay.MN 55323 ' � : .' ' ' ," . ,:'�• : '•. <br /> APProvtd�$Y.��'R�uiic�d);:.,..;.�. <br /> , �'����� (952)249-4600 . <br /> CYTY OF O�t,ONO-3EWEYt&'WATER/ GEN�YtAL PERMIT <br /> (-Nota Somc permiu may roqu�re'irpr°val by che Suilding Officinl and�a Public W�ks Drpurrnxni') <br /> �1_L Y'� M1'�'S- Msv be aubicc ru further ravi asd m v aat bE'+uucd w m the licatio is retEived <br /> ��'xB��-'��OR�VI,ATYON �� �,� . . :r ,. . . . .. . :., <br /> 1. you may apply for utiliry permirs by mail or in person at rhe City offices. <br /> 2. Mailed in applicauons are subject to the postage and 1�ndling fee shown below. Pem1it cards will <br /> be sent by rccum mail within 2 businesa days. <br /> 3. Permits are aat valid untII you receive 9 pe�mit card. <br /> 4. Work must not begin unless[he perntic Card is available on t�e job site. <br /> 5. Uriliry coanecrion perimts may be issued to]icensed conoractors only. <br /> 6. Contacc the Public Works Dcparnncnt(952-249-4600)foT utiliry stub as-builc locarions. <br /> DO NOT EXCAVATE YN AN'Y STR�ET AND DO NOT TAp ANY MAiN withoat express <br /> approval of the Public Works Department. Issuance of e peruuc dces nnc gram this approval. <br /> 7. All worl:must bz donc in accordance with State Code requirements. <br /> 8. All work must be inspected befvr�ir is covered. Call(952)249-4600,24+hour aocice required. <br /> .� � .a„�,��• ,.. . � :.3'ypE OF.�FvRMIT, ,� � , ,� ��� . � . . <br /> ,..�.� y� � . , �<<� � � <br /> � `'' . (cne�����.��.' ly �,. :� ,� , <br /> �Residential(May Require Approval) ❑Commercial(Approval Required) <br /> ❑New Connection ❑Addiuonal Connecdon ❑Re-Connectioa ❑Repairs �Disconaect <br /> ��ot�',Site�%�10wn��Tnforriiario�r• , �.;�� '� <br /> � <br /> Site Address: �1�� � �r1C� l��i �P� --- <br /> Qwner:�f'�yn��' ��'�' _ �(^� Mailing Address: I`J� C�.IQ(�(��R� <br /> City: � _ �' -I�I� z��: <br /> Home Phone: - Altemate Phone: <br /> �;CG01iQ'SCtE�C,�t"`a�3T�at10I�: � :�w��� '.r ',•, <br /> Conixactor: �� �� Contact Person: �N (��SC�n <br /> Address: ���� -�-n�%�� � State License#:�i��'� �6 r (',�',�� <br /> Cl�,. �� � Zip:��y��;�xpiration Date: N R • <br /> ���11� <br /> J <br /> Phone: C/Jo� - �•. ` AltexnatePhone: �oi,��-�o�.-����,� <br />