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DETERMII�IING PERMIT F'EES <br /> ❑SAC Charge(20i5 Rate=$2,485.00} $ <br /> (SAC Charge must accocnpany all sewer permit applicatians 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 i Repair(�50.00/Pei•Stub) $ � � <br /> Pipe size�inches;material_�Schd 40 air tested; cast iron <br /> [�Water Cor^�^tion/Disconnect/Repair($50.00/Per Stub) $ � � <br /> Pipe size_.]__inches;materiat_ x Schd 40 air tested; copper <br /> ❑Water Availability For F'uture liook-Up to Water(550.U0) $ __ <br /> Water Avaitabilitv E�inlanation: <br /> Contractor installed line to inside of house for futw•e hook-up. <br /> This line will be inspected by the Public Works Department. <br /> Required Before VlWater Connectian Permit is Issued: <br /> 1. issue Water ivleter&Horn Permit <br /> 2. Any Additionai Connection Fees Paid(7f Applicable) <br /> Issue Water Connection Permit: <br /> 1. Collect Permit Fee&issue Water Connection Permit <br /> LR� <br /> I. 5UBTOT'AL of Permit Requeszed: $ C G� <br /> 2. STA"I'�SUftCHARG�' � 5.00 <br /> 3, PO5TAGE&HANDLING(Only on Mail-In Applications) $ 2.00 <br /> �Y2' <br /> 4. TOTAL P�:RMIT FEE(Add Lines 1-3 Above) $ �U � _�- <br /> �-- ADDITIONAL INFORMATION—WATER IVIETERS <br /> ■ WATER METERS must be picked up and paid for at Urono City Hall,these are on a senarate permit. <br /> ■ WATER METFRS must be set and sealed by Orono Water Department (952) 249-4600, upon <br /> completian of ineter installation. <br /> The undersigned hereby applies t the City of(�rono for issuance of a Utility Permit, agrees to do <br /> all work in strict.accordance wit ' �e ardinances of the City and the regulatians of the State of <br /> Minnesota, an ce�tifies that all s ernents made on this application are,true and correct. <br /> Applicant: � Date: � Z �' � � <br />