Laserfiche WebLink
r . <br /> 1 <br /> � FOR CITY USE ONLY <br /> ,��� City of OrOno Date Received: Permit# <br /> O r � P•O.Box 66 <br /> #,;.; 2750 Kelley Parkway ❑In-House SAC Determination Form Completed <br /> � ��j�'?'�:-" � Crystal Bay,MN 55323 <br /> �^ �T�j��;��o (952)249-4600 Approved By(If Required): <br /> �eaxoa <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 application is received) <br /> GENERAL 1NFORMATION <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 rehun 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 peimit card is available on the job site. <br /> 5. Utility connection peimits 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 pernut 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 PERMIT ' <br /> (Check All That Apply) <br /> Residential(May Require Approval) ❑ Commercial(Approval Required) <br /> ❑New Connecrion ❑Additional Connection ❑ Re-Connection ❑Repairs ' connect <br /> Job Site/ Owner Information: <br /> Site Address: ,� �J�'--� /�C>,�'...f� ������_ ,��. ���- <br /> Owner: Mailing Address: <br /> City: ���c:� Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> 4;L c �� <br /> Contractor: Glf��%�.- �������;�-� Contact Person: �,✓✓ � �.������d��� <br /> Address: f'y����� � �is� State License #: <br /> City: �'�����'%``j"� Zip:.>S-��%Expiration Date: <br /> Phone: `�S��- �'�.s ' S°�� Alternate Phone: ��G'�.s"��L`-/G�� <br /> 4 <br /> ;i <br /> ;I <br /> � I 5 <br /> � � <br /> +� � �� .� I� � � I <br /> . � ; ' � k ,;� . <br /> I� . . . .. I ij j'. � .� � �. � � ! I„�� }' � <br /> ( i '��� � ' � I � . 4 j$ <br /> .. . . . . �I '�i '.�R:' . . ��.: � .ii . :�' e k.N� � . . <br />