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VIA cnv USE ONLY <br /> City of Orono Datc Ihr3rved: Pit# <br /> P.O.Box 66 <br /> 2750 Kelley Parkway ©b4fouse SAC DoWmbation Form Completed <br /> Crystal Bay,MN 55323 <br /> 952 <br /> ( )249-4600/Fax(952)2494616 Approved By(]f l�uired): <br /> �Xa.cHn <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 aonHcation is received) <br /> GENERAL INMRMATION <br /> I- 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 Off`PEIMT <br /> Check All Tim A <br /> [ esidential(May Require Approval) E]Commercial(Approval Required) <br /> New Connection ❑Additional Connection ❑Re-Connection ❑Repairs ❑Disconnect <br /> ❑ Water Availability Connection For Future Hook-Up to Water <br /> Job Site/Owner Infor flon: <br /> _Site Address: / LIo NAem Ave- <br /> Owner:. <br /> VCOwner: ! 3 Mailing Address: <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> Contrac�ax Im�ormaton: <br /> Contractor: 5C�Jki Z (044ia,-, Contact Person: <br /> Address: [Wo 117' Avl- uv State License #: <br /> City: I 'Q lJt Zip:J J)U q Expiration Date: <br /> Phone: 763- 6 -144 Alternate Phone: <br />