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FOR C41TY USS OhH,I <br /> (...-07,„,, City of Orono !bate Rgcetved, r',Pernut <br /> P.O.Box 66 <br /> it 0 2750 Kelley Parkway i,[]'Iii HOuse SAO:Det°erminatton Form Co Meted <br /> �"'� . Crystal Bay,MN 55323 <br /> �, ,t .yo (952)249 4600 .,Approed By(IfRequlre�l):; 36 <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 /> I <br /> 7 'F, I i k cV �': F E <br /> { TYPE OF P:ER�+ITT � � {� �� {• <br /> ,(Cheek All' that ilpply) ': <br /> Residential(May Require Approval) E Commercial(Approval Required) <br /> E New Connection ❑ Additional Connection ❑ Re-Connection ❑Repairs ❑ Disconnect <br /> Job Site=/ Owner Information: <br /> Site Address: /o? 00 (DU_ C .-\- Uo- <br /> __ <br /> Owner: ( \Sc\cx,3 _ Mailing Address: <br /> City: ,c-orco Zip: ' S3q\ <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> Contracto -0\0 rp Contact Person: 1 GL.r\U 4 <br /> Address: I 6 rtl .p. I.r4v&-\ -‘,U2 State License #: c\;3r11 P <br /> City: \'1' bc' C _ Zip:SB9SExpiration Date: I a-3\-p L <br /> Phone:c1,9-c3' Alternate Phone: <br /> X '',1 ,I J A,. <br /> ic <br /> i 1 1 II ) IJ �� 1l p 'il i `fi t 1 1 1 ., <br />