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.. tlia3/// <br /> . 455 00 <br /> s. <br /> 0 , City of Orono Dnate Received: P <br /> (70 0 P.O.Box 66 ;;;e! <br /> : <br /> r 2750 Kelley Parkway In-House SAC Determination F0,:::,,,,I.,(::::,,,, <br /> e - <br /> 4, Crystal Bay,MN 55323 <br /> \ �.�;�I, (952)249-4600 Approved By(If Requirer8) <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 /> GENE° 1O TIO <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 /> {`4 T <br /> .(Check Ail'�atApp y) ' „ <br /> ❑ Residential(May Require Approval) ❑Commercial(Approval Required) <br /> ® New Connection ❑Additional Connection ❑Re-Connection El Repairs El Disconnect <br /> El Water Availability Connection For Future Hook-Up to Water <br /> jeb SiteigN Tcnn aa' n , <br /> Site Address: 4th O k.1> GyJStA- 'kr-7 Ca.-) <br /> Owner: 1-?--�/'.-e^ Ced'ndiA,40.n.c) Mailing Address: .fid+ C. As 7h c r <br /> City: ' k/PS Zip: G.) <br /> Home Phone: 6(Z 4/Q L— Q'wO Alternate Phone: <br /> .Contactor.) formation: <br /> Contractor: VbSc✓x P((.. s b(64 Contact Person: r.A.v4L (jos.) <br /> Address: Lc-c-- , h Cr� State License#: G 7 <br /> City: ti-/)kt''s Zip:S3 '2 Expiration Date: (if Xf/ / z <br /> Phone: 1S/.- 53S�—y 3 OL Alternate Phone: 6c?- 9L( 53. 6 <br />