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, � <br /> ' � <br /> �__-�... �c��cTTx us�or��,� � a 3 � <br /> ,�/�t�rO� City of Orono Date I2eceivea:��/�;�� Pertnit#�Qf�y` <br /> P.O.Box 66 <br /> 2750 Kelley Pazkway ❑In-House SAC i7�temaination F�rm Cpt�ipl�ted <br /> �y �r Crystal Bay,MN 55323 �Q�,�� <br /> ��`�� ��� (952)249-4600 ApprQved�}�(I3'Rea�air�d): <br /> ��r`s n���"j" <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- Mav be subiect to further review and mav not be issued when the aoplication is received) <br /> GrEAtEIZt4L QI�MATIC�N ' <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 befare it is covered. Call(952)249-4600,24+hour notice required. <br /> ; ' TYPE OF'PERMIT <br /> ' (Check All That A i ) ; <br /> �esidential(May Require Approval) ❑ Commercial(Approval Required) <br /> ❑ New Connection ❑Additional Connection ❑Re-Connection ❑Repairs �isconnect <br /> ❑ Water Availability Connection For Future Hook-Up to Water <br /> Tob Site I Own�t'Inforn��tion: ' <br /> Site Address: a��� � �''�`� 1`�C/ <br /> Owner: 5 �-�T/►r`� Mailing Address: <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> Contraetar Inf`�mation: <br /> Contractor: +U-5. �'1 � �t,- Contact Person: V�I`k e /�.�v�.-f— <br /> Address: 2-`l I(o �i�t.ta-/A+�P State License#: � 4 3 ov 30 <br /> City: � Zip: SU� Expiration Date: <br /> Phone: !o �!- �l�0�'13 SS Alternate Phone: � �1-91�-�!3 y d <br />