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• SENLY <br /> — '4 City of Orono <br /> gDate lteeei a y ennit# •" � �l <br /> / 'C) P.O.Box 66 <br /> r,e 2750 Kelley Parkway Q In HouseSAC Detetmpnation Form Completed, <br /> Crystal Bay,MN 55323 <br /> ';- 6 (952)249-4600 Alrproved By(If Required) <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 INFORMAT ON <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 /> TTYPE PET <br /> ❑Residential(May Require Approval) ❑ Commercial(Approval Required) <br /> Tew Connection ❑Additional Connection ❑Re-Connection ❑Repairs ❑Disconnect <br /> ❑ Water Availability Connection For Future Hook-Up to Water <br /> rob.Site 1 Owner T11ti atl{311 ; <br /> Site Address: /0C, 0 r 0 V\ 0 c-C (-\,q 444, 5 , <br /> Owner: r c,`)II I <br /> � h A t A \A Mailing (.1)4,0 no Address: � o doh .41v,dlo <br /> City: - - <br /> Zip: 3 4t I <br /> Home Phone: 7 S 2 -(-47 --LC 2.lQ Alternate Phone: <br /> Contractor Information: <br /> Contractor: Ctb 5 , 4)u- , Contact Person: t `—, <br /> Address: '1 State License#: <br /> City: 4A \42-A- Zip:/v Expiration Date: 2/21 / (o <br /> Phone: 1 .6 3 14'? -- 11--- Alternate Phone: <br /> Co' z-- 2 s(3-63Y.-- <br />