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• � <br /> FOR CITY USE ONLY <br /> ��(��� City Of 01'ono Date Received: Pennit# <br /> O 7 O P.O.Bo�66 <br /> ,y;e. 2750 Kelley Parkway ❑In-House SAC Determinatioti Form Completed <br /> �� yS�?1;r,�;: ,� Crystal Bay,MN 55323 <br /> L�,���o�a`o (952)249-4600 Approved By(If Required): <br /> `�._.___. <br /> CITY OF ORONO—SEWER& WATER/GENERAL PERMIT <br /> (*Notc:Some permits may require approval by the Building Official and/or Public Works Department*) <br /> (ALL PERMITS- M:�v be subicct to further review and m�rv not be issucdµ�hen the annlicAtion is received) <br /> GENERAL 1NFORMATION ' <br /> 1. You may apply for utility pennits 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 stu6 as-built locations. <br /> DO NOT EXCAVATE 1N ANY 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 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 /> TYPC OF PERMIT ' <br /> Check All That A I ) <br /> �Residential(May Require Approval) � Commercial A roval Required) <br /> �New Connection ❑Additional Conn on Re-Connection Repairs � Disconnect <br /> Job Sitel Owner lnformation: <br /> Site Addcess: �o��CJ� /C�F Si�.O�2e .��2 <br /> Owner: Mailing Address: <br /> City: Zip: <br /> Home Plzone: Alternate Phone: <br /> Contractor Information: <br /> Contractor: �i2� ��� Contact Person: �e!( �,�-�-ti. <br /> Address: I/'�3�5 �I State License #: ���/Z- <br /> City: �� fuf�/ Zip:�_�Expiration Date: f,P2�,�j�0 `7 <br /> Phone: IiS'o?"'�YG`F✓��y Altern�te Phone: <br /> GI,2-3�3�/f`'8 /s'` <br /> 7� o0 <br />