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. <br /> f� FOR CITY USE ONLY <br /> � �' � \ City of Orono Date Received: Permit# <br /> ;i 0� �0" P O.Box 66 <br /> �� n; �� 2750 Kelley Parkway ❑In-House SAC Determination Fotm Completed <br /> �� �;X`� �;• �� Crystal Bay,MN 55323 <br /> ���E,¢,�� (9�2)249-4600 Approved By(If Required): <br /> i'�z�o*j <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 /> (ALI.PERMITS- Mav bc subiect to further review and mav not be issued when the aoplication is received) <br /> GENERAL INFORMATION <br /> l. 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. 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 1N AN�'STREET AND DO NOT TAP ANY MAIN without express <br /> approval of the Public Works Department. Issuance of a permit does not grant this approval. <br /> 7. All work must be done it� 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 /> esidential(May Require Approval) � Commercial(Approval Required) <br /> � � New Connection ❑Additional Connection �"[�e-Connection epairs ❑ Disconnect <br /> Job Site/Owner Information: <br /> Site Address: �S 7� <br /> Owner:_��/s� ���Z Mailing Address: SQ�r-�P <br /> City: (�N�► � Zip: <br /> Home Phone: Cf s���1 ��3y Alternate Phone: <br /> Contractor Information: <br /> Contractor: -�u;�;'�'�c�,e� �-�"�'i! � Contact Person: B�' /LG' <br /> Address: � �� �� State License#: <br /> City: �1� " Zip:�s�� Expiration Date: <br /> Phone: ���' �j`� y/v �l y Alternate Phone: �/�- �G�'/ �39 <br />