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� • <br /> FOR CITY.IISE O1�I�.Y <br /> O,�Q�O City of Orono Dats Received: Persnit# <br /> P.O.Box 66 <br /> 2750 Kelley Parkway 0 In-House SAC DeterminaGon Form Completed <br /> � � Crystal Bay,MN 55323 ' <br /> ,��� (952)249-4600 Approued By(if Requiredj: <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 /> (ALL PERMITS- Mav be subiect to further review and mav not be issued when the aoolication is received) <br /> �ENERAI,I1�FORMATI�N <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 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 IN 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 /> TYPE OF PEI�T <br /> ". . Checic A�1:Tliat A� 1 <br /> �.Residential(May Require Approval) �Commercial(Approval Required) <br /> � New Connection ❑Additional Connection �Re-Connection �Repairs ❑Disconnect <br /> Jc�b Site 1 iDwner Information: ;: <br /> Site Address: ,���s /�/o�1 T�� �'yo�' �/? <br /> Owner: ��/� C��L' l''�� ,,� Mailing Address: <br /> City: �,//� �O Zip: Ss ,7 �/- �7l/ <br /> Home Phone: Alternate Phone: <br /> Contractor Information: ' <br /> Contractor: � D jd /�p p��;� Contact Person: �D� <br /> Address: / 5'.s�O „���9✓� i; State License#: <br /> City: /"'�/! Zip:S��JExpiration Date: <br /> Phone: Alternate Phone: <br />