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2007-P11102 - sewer/water permit
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2216 Shadywood Road - 17-117-23-42-0004
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2007-P11102 - sewer/water permit
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Last modified
8/22/2023 3:40:28 PM
Creation date
10/2/2018 2:10:22 PM
Metadata
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x Address Old
House Number
2216
Street Name
Shadywood
Street Type
Road
Address
2216 Shadywood Road
Document Type
Permits/Inspections
PIN
1711723420004
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r � '" <br /> DETERMINING PERMIT FEES <br /> � SAC Chargc(2007 Rate=�1,675.00) � � <br /> (SAC Charge must accompany a}l se�ver permit app(ications unless prepaid) <br /> (Orouo City Staff can determine if applicable) <br /> (If not prepaid,� sewer connection permit will not be issuect) <br /> O� Sewer Con t on/Disconnect/12epair 35.00/Per Stub) $ <br /> Pipe size�inches; material_ Schd air tested; �_cast iron <br /> � �i��ter Coni c�tion/Disconnect!Repair(�35.00/Per Stub) � <br /> Pipe size � _inches; material Schd 40 air tested; � copper <br /> r) �l l c� <br /> V" <br /> 1. SUI3TOTAL of Perii�it Requested: $ <br /> ?. STA"I'E SURCHARGE $ .50 <br /> 3. POS"CAGE& 'rlr�ivDLING (Onfy on Ylail-In Appiications) S 1.50 <br /> =0. TO'I'AL P�l21IlT �'E� (Add Lines 1-, r�bove) $ <br /> ADD[TIONAL INFORMATION - WATER METERS <br /> ■ �1'A'fER l�'IGTERS must be pickcd up and paid for at Orono City Hall,these are on a seqarate pennit. <br /> a Wf�'T�:I2 I�1GTGl2S must be set and sealec� by Orono Water Dep�►•tment (9�21 2-t9-�1G00, upon <br /> completiun of mctcr installation. <br /> The undersigned hcreby applies to the City of Orono for issuance of a Utility Permit, agrees to do <br /> all w�ork in strict accordance with the ordinances of the City and the regulations of the State of <br /> Minnesota, and certifies that all s teme made on this application are, tcue and correct. <br /> / � � <br /> Applicant: ��'"- - Date: <br /> Reset Form <br />
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