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.... _ . <br /> j�'�T R�TC3'�EI�:I'i'FE�S <br /> ❑SAC Charge(2015 Rate=52,485.00) � <br /> (SAC Charge must accompany all sewer permit applicadons 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/Repalr($50.00/Per Stuti) S <br /> pipe size�inches;material� Schd 40 a'v tested; cast iron <br /> (�Water Conn�tion/Disconnect/,R,�e�air($50.00/Per Stub) $ <br /> Pipe siu,L_inches;material r""� Schd 40 air tested; copPtr <br /> ❑Water Availability For Future Hook-Up to Water(550.00) � <br /> Water Availabilitv E�rnlanation: <br /> Contractor installed line to inside of house for firture hook-up. <br /> This line will be inspected by the Public Works Deparnnent. � <br /> Rcquired Before Water Connection Permit is Issued: <br /> 1. Issue Water Meter&Horn Permrt <br /> 2. Any Additional Connection Fees Paid(If Applicable) <br /> r��ue Water C��►ection Permit: <br /> 1. Collect Permit Fee&Issue Water Connection Permit <br /> 1. SUBTOTAL of Permit Requested: � <br /> 2. STATE SURCHARGE a 1'� <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applicarians) $ 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) s <br /> ADDITIONAL 1NFORMATT03�T-WATER METERS <br /> • WATER METERS must be picked up and paid for at Orono City Hall,these are on a seoarate,permit. <br /> ■ WATER METERS must be set and sealed by Orono Water Department (95Z) 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 /> Applicant: � Date: 3��,�g <br />