Laserfiche WebLink
ot <br /> P <br /> FOR CITY USE ONLY <br /> ¢0 . City of Orono Date Received: Permit# <br /> `Y P.O.Box 66 <br /> O4 0 2750 Kelley Parkway 0 In-House SAC Determination Form Completed <br /> a ? Crystal Bay,MN 55323 <br /> ii4o of (952)249-4600 Approved'By(If Required): <br /> R s o$,4' <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 /> Q Residential(May Require Approval) ❑Commercial(Approval Required) <br /> New Connection ❑Additional Connection ❑Re-Connection ❑Repairs ❑Disconnect <br /> Job Site/Owner Information: <br /> Site Address: ( (6- aX ) I 1-,A- ..e \e._046 <br /> Owner: ,---- d- Cee (AJ Mailing Address: <br /> City: Zip: <br /> Home Phone: 615 2- ick)- 1'11 0 Alternate Phone: <br /> Contractor Information: <br /> ( <br /> Contractor: (.,(�.5 ( - Contact Person: e2 14 <br /> Address: (c0 ( CO 2d 1 S State License#: 1 8 ( P4 . <br /> City: I14.0()`<-d Zip:g 5 3 6 ifExpiration Date: LZ - ?/- b 6 <br /> Phone: qi s 2 `I12 _ qui'i' Alternate Phone: 6/z. -74i i ^ g 7 7 1 <br />