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.+-�t ' 'r '• <br /> . �:�' ,� <br /> ❑SAC Charge(2014 Rate=52,485.00) S <br /> (SAC Charge raust accompany alt sewer permit applicatioi�s unless prepaid) <br /> (Orono City Staff can deteranine if applicable) <br /> (IP not prepaid,A aewer connecttoa permit will not be issaed) <br /> �ewer Connection/Disconnect/Repa[r(SS0.00/Per Stub) S <br /> Pipe size inches;material Schd 40 air tested; cast iron <br /> �[j WAter Connectlon/Disconnect/RepAtr(550.00/Per Stub) $ <br /> � Pipe size inches;material Schd 40 air tested; copper <br /> ❑Water Av�iln6illty For Fnture Hook Up to Water(S50.00) $ <br /> WAt@i'AVA�IAII�II[V E7CDIADA[IOn: <br /> Contractor installed line to inside of house for future hook-up. <br /> This line will be inspected by the Public Works Department. <br /> Reauired Before Water Connection Pennit is Issued: <br /> 1. Issue Water Meter&Horn Pe�mit <br /> 2. Any Additional Connection Fees Paid(If Applicable) <br /> Issue VVater Connection Permit: <br /> 1. Collect Pc�mit Fee&Issue W�ter Connection PeaYnit <br /> 1. SiFBTOTAL of Permit Requested: � <br /> 2. STAT�SURCHARGE $ 5.00 <br /> 3. POSTAGE&HAIVDLING(Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERNIIT FEE(Add Lines 1-3 Rbove) g <br /> �DI�'I�'}�T,i�;�,IN��Rl�i�4'�'I+�N—W�TER:MET'F.I�:S <br /> • WATER METERS must be picked up and paid for at Orouo City Hall,these are on a separate permit. <br /> ■ WATER METER5 mnst be set and sesled by Orono Water Depatrtment (952) 249-4600, upon <br /> compietlon of ineter lnstallation. <br /> The undrrsigned hcreby applics to the City vf Orono For issuance of a Utility Permit, agrees to do <br /> all work in strict accordance witli the ordinances of thc City and the regularions vf the 5tate of <br /> Mimiesota, and certifies thai all statements made on this application are,hue aud correct. <br /> . <br /> Applicant � Date: I O-�_��� <br />