Laserfiche WebLink
FOR CITY USE ONLY <br /> 4�,�` City of Orono Date Received: Permit# <br /> `r P.O.Box 66 <br /> �a�..,,,, O 27�0 Kelley Parkway ❑Tn-House SAC Determination Form Completed <br /> ,��'� �; `-` Crystal Bay,MN 55323 <br /> ��^����;�.�o`� (9�2)249-4600 Approved By(If Required): <br /> saxoa <br /> CITY OF ORONO- SEWER& WATER/ GENERAL PERMIT <br /> (*�Iote:Some permits may require approval by the Building Official and/or Public Works Department*) <br /> (.4LL PERMITS- Mav be subiect to further review and mav not be issued when the npnlication 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 haiidling fee shown below. Pernut cards will <br /> be sent by return mail within 2 business days. <br /> 3. Permits are not valid until you receive a pernut card. <br /> 4. Work must not begin unless the peinut 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 requu�ements. <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 /> 1 <br /> ❑ New Connection ❑Additional Connection ❑Re-Connection ❑ Repairs �isconnect <br /> Job Site/ Owner Information: <br /> L �. r Cr � � Yy V ,\ V"� <br /> Site Address: � J > -� J� � � �T�2� � <br /> Owner: ��f��� �� ��V •>P��� Mailing Address: �`� �v ��'��`����-�'"R' �� <br /> ,) sa� i ��'`�� ,�ALI` <br /> City: Zip: �S 3�7 " <br /> � <br /> Home Phone: Alten�ate Phone: � �j !°2 �6 � "D 4��� <br /> Contractor Information: <br /> d ���� r L1� � y�s�� <br /> � <br /> , ��� � _ ,�1 rr�^'� <br /> Contractor: �d'`' w�I��� � �"` � Contact Person: ����� � Y`� <br /> Address: State License #: � ��� <br /> City: Zip: Expiration Date: <br /> Phone: �l�- ���� � � � �� Altenlate Phone: <br />