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Aar-25-2006 11:43am From-CITY OF ORONO +9522494616 T-314 P.001/001 F-052 <br /> f . <br /> ��FOIt CITY US�OP�L1Gi' <br /> DaLe R�caw�1:� ,�;. Pcmrtt# �� <br /> City oiOrono . • , �, ' ;. ' <br /> '��� p,p.Box 66 ��,_kqy�SAC petertrrination Form Completed <br /> 0•. � 2750 Ktlfcy Parkway . � , <br /> ���d� Crybtal Bay�MN 55323 APP�oved Sy�f Required): . <br /> (952)z49-A600 <br /> �o CIT'Y OF ORONO—SE�ER&'WATEYt/GENERAL pERM�T <br /> (•Notc:Same pe„ni�s rrn�y raqu�re flFP�o.'a1 by the B�;iding OY�icial andlor Public works I�epanment') <br /> �/�t, PE i be sub'e to r revl w a ms� nnt e iasu wh n the lic, ion recC' ed) <br /> CYENERAL 1NFORMATIQN - ' . <br /> 1. you may apply for ucilicy pei�u by mait or in person ac the City office6. <br /> 2, Mailed in applications are subjecc to ti�e posca�e and handling fee shown betow. Pormit eards will <br /> be seut by Teturn mail withu►Z business days. <br /> 3. Permits are not volid uneil yau receive a permit card. <br /> 4, Work must not bcgin ualess the permit card is available on the job site. <br /> 5. Utility conneetion pennits may be issutd to tieensed conocactors on1y. <br /> 6. Contact Lhe Publie Works DepaT�►ent(952-249-4600)for utility stub as-built locations. <br /> DO N�T'EXCA�ATE IN ANY STRTE'f AND DO 1vOT TAP ANY MAY1�I without enpress <br /> approval of the Pubtic Works Dep�ctment. Issuauce of a permit does not granc dus approval. <br /> 7, All work inust be done in accocdance with State Code requiremcnts. <br /> 8, All work must be iuspected befon it is eovered. Call(952)z49-46W,2a+hour notice required. <br /> � . • TYPE`OF�PERMY'T , � � � . � - . ' <br /> � � , � � (Check Al1 That A 1 ) . . �` �� � . <br /> �Residential(I�tay Require Approval) ❑Commercial(Approyal Required) . <br /> ❑New Connection []Additional Co�ecrion ,�RaConnection �Repairs ❑Disconneet <br /> Job Site/Owaer Information: <br /> Site Address: I r �� <br /> Owner: <br /> � � -�1��� Mailing Address: ���-"-`�-�' �� <br /> 1 <br /> : c�cy: ����.`�-�.1�-�-- zip: , <br /> Home Phone: � Altemate Phone: � <br /> , Contractor Information: <br /> � Contractor: (�;L,�n ��r � �o�tact Person� �) <br /> � (�7(� 1 n� n��K'I (� State�.icense#: �� '��' <br /> � Address: �'/� <br /> �,� , �j Zip��xpiration Date: �-� <br /> . City: <br /> � ��_ ,��C��—�j�;�� Alternate Phone: �Q1p�_"Z�C��`�'� <br /> . Phone� <br />