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� <br /> v <br /> . ... . . . � . "�A'i�it7�'47�i'iL�1Wi11.�'�317 � . . . .. . . ... . <br /> ❑SAC Charge(2015 Rate=52,485.00) $ <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 Con �i�on/Disconnec /Re si .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 Availabilftv Ernlanatlon: <br /> Contractor installed line to inside of house for firture hook-up. <br /> This line will be inspected by the Public Works Department. , <br /> Required Before Water Connection Permit is Issued: <br /> 1. Issue Water Meter&Horn Permit <br /> 2. Any Additional Connection Fees Paid(If Applicable) <br /> Issue Water Connection Permit: <br /> 1. Collect Permit Fee&Issue Water Connection Permit <br /> 1. SUBTOTAL of Permit Requested: � <br /> 2. STAT'E SURCHARGE $ 1.00 <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applicarions) $ 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ <br /> ADDITIONAL INFORMATION-WATER METERS <br /> ■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a s�arate permit. <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 r e wrth e ordinances of the City and the regulations of the State of . <br /> Minnesota,and c fies�� a 1 e �e�on this application are,true and correct. <br /> ;� '� � /�- �7 �� <br /> Applicant: � G Date: <br />