Laserfiche WebLink
• RECEIVED <br /> SEP 112017 <br /> — FOR CITY USE ONLY 1)-15//6 <br /> -9.-0/1/,.., City of Orono CITY OF ORONODate Received: Permit# <br /> P.O.Box 66 <br /> 2750 Kelley Parkway 0 In-House SAC Determination Form Completed �y <br /> Crystal Bay,MN 55323 /6,3 (/ <br /> tp <br /> (952)249-4600/Fax(952)249-461 J Approved By(If Required): <br /> \, IktsH ON°, <br /> V,v <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- May be subject to further review and may not be issued when the application is received) <br /> GENERAL INFORMATION <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 PERMIT <br /> (Check All That Apply) <br /> Residential(May Require Approval) ❑Commercial(Approval Required) <br /> ❑ New Connection ❑Additional Connection ❑ Re-Connection ❑RepairsDisconnect <br /> EI Water Availability Connection For Future Hook-Up to Water <br /> Job Site/Owner Information: <br /> Site Address: 2(.0 Z S k 1 j Ye. 0 vo Vl 6 <br /> Owner: £1 1 etk te_e(iL n Mailing Address: Z10 Z5 16,11_J� Eve_ <br /> 1 <br /> City: OVYLO Zip: SS 3 31 <br /> Home Phone: Ce ( Z 3100 Z(o(o Alternate Phone: <br /> Contractor Information: <br /> Contractor: J&s4- wcVLt-eo lt,t... Contact Person: r C.l a, <br /> Address: I 030 La-W-0)1 frfVQ tEState License#: <br /> City: 4-{Q,it,aNtV Zip:$53 I Expiration Date: <br /> Phone: 71, 3 -9 Z J — 9 030 Alternate Phone: I Vl eJ SS4C44)a4 ,Cow\ <br />