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<br /> ❑Sr�C Charge(ZOX6�t,ate=�2,4$5.00) $
<br /> (SA.0 C6arge must accompany all sewer�emait app��catioz�s unless prepaid)
<br /> (Qrono City StafFcan detez�miaae if appl'zcablc)
<br /> (Yf not pre�aid,a sewer cvianectio�o peXmit wili nat be issned)
<br /> �[Sewer Cunnectian/Disconnec epalr SO.00/Per Stnb) S
<br /> '� Pipe size�inches;xnate�za� c�d 40 sir tested; cast iron
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<br /> ❑Water Can�ectian/Disconnect/Re�raiur(�SO.ItOl�er Stub) $_
<br /> Pipe size iacb�es;lt�ateri.al, Schd 40 air tested; cop�er
<br /> ❑Water Availability�'ox k'uture Hduk-U�to Water($50.00) $
<br /> Wate�r Avaitabilitv Eaolanat�an:
<br /> Contractor installed line to ins�de of k�ouse�or�utzu�hook-up_
<br /> This line wi�l be i�s�cted by the PubIic Works Departmen�
<br /> Re uired Befare Wate�r Co e 'on Permit is Issued:
<br /> l. �ssue Watcr Meter&Horn Permit
<br /> 2. Az�y Additional Cormection Fees Pai�d(If Applxcab[e)
<br /> Issue Water Cflnnect'ton Permit:
<br /> 1. Cnllect Permit Fee&�ssue Watez Co�an,ectian Permit
<br /> 1. S"UBTOTAL of Pernait Requested: � � ' �a
<br /> 2. STA,�'B SURCHA�QE $ 1.00
<br /> 3. �OS�'AGB&HANDLTNG(Only on Mai�-�r�.A.��lications) $ 2.00
<br /> a, '�O�'.A,�.���T FEE(Add Lines 1-3 Above) $ ��• ��
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<br /> ■ V�'ATER 1VI��'EktS baust be picked up and paid for at Ocano City Hat�,Lhese are on a senarate permi�
<br /> ■ WATER METERS mnat be set and sealed by Oronv Water De�art�ment (952} 249�600, upon�
<br /> . eo�n��e#io�of nr�eter ins�allation.
<br /> T'he undersigned hereby a���ies to the City of Orono for issuaxxce o�a Ut�lity�ermit,agrees to do
<br /> all woz� iva stnict accorda�ace with the arditiances o:F th,e Caty a�,d the regulations af the State o;f
<br /> n innesota,and ee�'tx�ies tb�at a1,�statements made on this appliea�ion axe,tzue ap,d correct.
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