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0411412015 10:12 A?{} P.0011002 <br /> 4QQ0 P.O. ax O�rouo Data.•R6c61ved' Pernllts / �� <br /> 2750 Kelley Parkway+ (]%Gtn>ipi>se.SAt UemrtoindNOn$orm�Com�lated <br /> A Crystal Bay,MN 55323 <br /> 0fflo (952)2494600/Fax(952)249-4616 Approved:Byr(•IFltequ' a 7 <br /> CITY OF ORONO—SEWER&WATER/GENERAL PERMIT "M-v Irl' <br /> ("Nota:Some permits may require approval by Itis Building official and/or Public Works Dent°) <br /> (ALL PRAM 3- May be sublect to further review and may not be Wad when the soolicatten reeelved) <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. Ptirmit 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. Coll(952)249-4600,24+hour notice require. <br /> TYPE OF PE <br /> k A-11 T A f <br /> Residential(May Require Approval) ❑Commercial(Approval Required) <br /> ❑New Connection ❑Additional Connection Are-Connection []repairs ❑Disconnect <br /> ❑ Water Availability Connection For Future Hook-Up to Water <br /> Job SiteAwner fi&rlxl� <br /> Site Address: 6(4�0 A2 Shore— Vc• ^O <br /> Owner: Mailing Address: <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> ontractar Infarmatlon: <br /> Contractor: /Klnavha Vjct— aorkontact Person: a <br /> Address: GXqir_ S?E 1bS State License#: My l <br /> City: U� e7c l�e, Zip: $33;7Expiration Date: <br /> Phone: �1 -�'��l qgj3 Alternate Phone: <br />