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� <br /> D�'�E��P�I�I`�'FE� <br /> ❑ SAC Charge(2015 Rate=$2,485.00) $ <br /> (SAC Charge must accompany all sewer permit applications unless prepaid) <br /> (Orono City Staff can determine if applicable) <br /> (If not prepaid,a sewer connection permit will not be issued) <br /> �Sewer Connection/Disconnect/Repair($50.00/Per Stuti) $ <br /> Pipe size inches;materia] Schd 40 air tested; cast iron <br /> (�Water Connection/Disconnect/Repair($50.00/Per Stub) $ <br /> Pipe size inches;material Schd 40 air tested; copper <br /> ❑ Water Availability For Future Hook-Up to Water($50.00) $ <br /> Water Availabilitv Eznlanation: <br /> Contractor installed line to inside of house for future hook-up. <br /> This line will be inspected by the Public Works Department. <br /> Re uired Before Water Connecrion Permit is Issued: <br /> ]. Issue VJater Meter&Horn Permit <br /> 2. Any Addirional Connection Fees Paid(If Applicable) <br /> Issue Water Connection Permit: <br /> ]. Collect Permit Fee&Issue Water Connection Permit <br /> 1. SUBTOTAL of Permit Requested: � <br /> 2. STATE SURCHARGE $ 1.00 <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ <br /> ADDITIONAL INFORM�TiON-WATER I�IETERS <br /> • WATER METERS must be picked up and paid for at Orono Ciry Hall,these are on a se�arate pemvt. <br /> • WATER METERS must be set and sealed by Orono Water Department (952) 249-4600, upon <br /> completion of ineter installation. <br /> The undersigned hereby applies to the City of Orono for issuance of a Utility Permit, agrees to do <br /> all work in strict accordance with the ordinances of the City and the regulations of the State of <br /> Minnesota, and certifies that all statements made on this application are,true and correct. <br /> -� <br /> Applicant: <br /> Date: � � ^_.1 <br />