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f.O.�, �QR C�USE O1VLY� <br /> i 1 � N�� City of Orono I�te Re,c�;ved: �f�erinit# � �� <br /> ( P.O.Box 66 ` ` <br /> 2750 Kelley Parkway ❑In-House 5AC Dete i ai�jon�Forni Compl <br /> i`� �,� Crystal Bay,MN 55323 �� }���%a`�'y�"�,��� <br /> t,\xKF,N"��'L�' (952)249-4600/Fax(952)249-4616 APPraved�By(IfReqwred): ... � <br /> CITY OF ORONO—SEWER&WATER/GENERAL PERMIT <br /> (*fYote:Some permits may require approval by the Building Ufficial and/or Public Works Department•) <br /> (ALL PERMITS Mrv be subiect to furt6er review and mrv not be issued w6en the aoolicatiqa ia received) <br /> GENERAL 1NFORMATION <br /> 1. You may apply for utility permits by mail or in person at the City o�ces. <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. Contaet the Public Works Department(952-249-4b00)for utility stub as-built locations. <br /> DO NOT EXCAVATE IN ANY STREET APiD DO NOT TAP ANY MAIN without express <br /> approval of the Public Works Department. lssuance 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. Calt(952)249-4600,24+hour notice required. <br /> TYPE OF;PERiVIIT <br /> ' Check All That A 1 <br /> ��Residential(May Require Approval) ❑Commercial(Approval Required) <br /> � � <br /> ❑New Connection ❑Additional Connection �Re-Connection ❑Repairs ❑Disconnect <br /> ❑ Water Availability Conne�ction For Future Hook-Up to Water <br /> 7ob Site/Uwner Information. ` <br /> Site Address: t-'�� � ~` � " � � <br /> � `� <br /> Owner.' ' 1 ��i��-�Iailing Address: ����: t�,f T:��'?.t:�fl'Y",�/��?/ <br /> City: I�, '�nr� �� �� Zip; � �:- �:- <br /> � � <br /> Home Phone: `� Altemate Phone: <br /> Contractor Information: ,,___,, <br /> � i <br /> Contractor: � ` '��" � .`l j�� Contact Person: �' ,� <br /> . - { l �� -�,^r � <br /> Address: � 1 f'�� t,�,�l.t.� s��.� � tate License#: E� �-4�� � t ,- �� � , <br /> � � <br /> City: �'��(��1���„��� Zip:`��� ExpirationDate: <br /> ,r�4. � , �r i `� '1 '�'c::.���I <br /> :�/� <br /> Phone: �� I 1��J• '� � �U�.. Alternate Phone: � _��� �-�� l� . � <br />