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. � <br /> Cl't'Y U�OIYLY <br /> ���0 City of Ornno Dau tt«xi�eed: Pefmit# <br /> P.O.Box 66 <br /> 2750 Kelley Parkway �In-Honse SAC Deteimination Frnm Completed <br /> a �- Crystel Bay,MN 55323 <br /> �`"�'�AESHo¢``�` (952)249-4600/Fax(952)249-4616 Approved By(IfRequired�: <br /> CITY OF ORONO—SEWER&WATER/GENERAL PERMIT <br /> (*Noh:Some peamits may require approvai by the Building Official and/or Public Works Departrnent+) <br /> (ALL PERM11'S- Mav be sobiect to fnrthv review and mav not be issued when ffie aoolieNne i:rr�.�.a� <br /> Gfil'�iERAi,IlVFORMATIOI� . <br /> 1. You may apply for utility permits by mail or in petson 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 yoa receive a permit card. <br /> 4. Work must not begin unless the permit card is available on the job site. <br /> S. Utility connection permits may be issued to licensed contractors only. <br /> 6. Contact the Public Works Department(952-249-4600j for utility stub as-built locations. <br /> DO NOT EXCAVATE IN ANY ST1tEET AND DO NOT TAP ANY MAIN withont ezpress <br /> approval of the Pubtic Works Department. Issuance of a permit dces 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 notiee required. <br /> ' TY�E O�PE�T <br /> Check All That A i.. . <br /> �esidenrial(May Require Approval) ❑Commercial(Approval Required) <br /> � t <br /> ❑New Connection ❑Additional Connection ❑Re-Connection �Repairs ❑Disconnect <br /> ❑ Water Availability Connection For Future Hook- p to Water <br /> Jo� Site/C)vvc�Er infor�ation: <br /> Site Address: a 7/S ��l`�C�� L� <br /> Owner: �1�`�� .J��21�r� Mailing Address: . <br /> City: (�l2 D I'�C� Zip: <br /> Home Phone: �o�z-38y"�'7U� Alternate Phone: <br /> � <br /> Contrac�or Information: � <br /> . <br /> Contractor: �i4P v,v�����zvc�D Contact Person: T�N�-t �l�t�i�� <br /> Address: �3�s�'2✓1C� f� State License#: �C (����1 z � <br /> City: �i oSe v���e Zip:S�/�3 Expira.tion Date: /-2` 3/�/7 <br /> Phone: �,Q �2- 2 z 2���z Alternate Phone: ���� y�3"3�yl <br />