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< �c��crr�rs�.c��v�X <br /> �,�0�� City of Orono IZateRecetued. ` Perniit�# <br /> P.O.Box 66 � � <br /> 2750 Kelley Parkway [�In-Hfluse SA�,Detecnrinatic�r►Form Completed ' <br /> � ,,, � Crystal Bay,MN 55323 <br /> ��p44 (952)249-a600 �rov�a ay(tf�uir�a: <br /> CITY OF ORONO—SEWER& WATER/GENERAL PERMIT <br /> (*Note:Some permits may require approval by the Building Official and/or Public Works Deparhnent*) <br /> (ALL PERMITS- Mav be subiect to further review and mav not be issued when the aoolication is received) <br /> GENERAL INFORMATTON " �' <br /> 1. You may apply for urility pernuts by mail or in person at the City offices. <br /> 2. Mailed in applications are subject to the postage and handling fee shown below. Pernut 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. Urility connection pernuts 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 pemut 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 PER�VIIT i <br /> ' (Check A11 That A 1 <br /> �esidential(May Require Approval) ❑ Commercial(Approval Required) <br /> .� <br /> ❑ New Connection ❑Additional Connection ❑Re-Connection ❑Repairs �Disconnect <br /> ❑ Water Availability Connecrion For Future Hook-Up to Water V <br /> Job Site/Owner Information: <br /> (�(/ (�U�(. �{K�-Q <br /> Srte Address: � t,� �� � � /�-�t - � K- <br /> Owner: //// G� h � e Mailing Address: `Z��� d��(f�'. �S <br /> City: d��� Zi S�'��� ��c <br /> P• <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> Contractar: /I I�'2(L s- ��C�Q'xc,Contact Person: /!�l.A�� l���14�'SZJGU <br /> �a��� <br /> Address: `S"U l f�`�u�- �iLfc.L State License#: <br /> Gvay?sr�'t <br /> City. Zip:�3R � Expiration Date: <br /> Phone: �O�Z '(��!S'���?2- Alternate Phone: <br />