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M , t <br /> ..... . ... � .. - <br /> �+''�.`C.�'�,.�. {�`{�7y� . .. . . .. . <br /> . .. , .. . . , . � �. :lJ�qA�E'i „�li�'� . �133�V��.� . �_� .. <br /> ❑SAC Charge(2015 Rate=$2,485.00) $ <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 /> �]C Sewer Connection/Disconnect/Repair(550.00/Per Stuti) $ .So , o 0 <br /> Pipe size " inches;material vL Schd 40 air tested; cast iron <br /> ❑Water Connection/Disconnect/Repair($50.00/Per Stub) $ <br /> Pipe siu inches;material Schd 40 air tested; coPPe�' <br /> ❑Water Availability For Ptiture Hook-Up tu Water(550.00) $ <br /> Water Availabilitv Eznlanatlon: <br /> Contractor installed line to inside of house for fiihu'e hook-up. <br /> Tlus line will be inspected by the Public Works Department. � <br /> It�,;*p�Before Water Connection Permit is Issued: <br /> 1. Issue Water Meter&Horn Permit <br /> 2. Any Additional C�nnection Fees Paid(If Applicable) <br /> Issue Water Connection Permit: <br /> 1. Collect Permit Fee&Issue Water Connection Permit <br /> t� s'U . 00 <br /> 1. SUBTOTAL of Permit Requested: �D <br /> 2. STATE SURCHARGE � 1.00 <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applicarions) S 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ `s� , � o <br /> ADDTTIONAL INFORMATTON—V►�ATER METERS <br /> ■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a seuarate pe�mit. <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 accordance with the ordinances of the City and the regulations of the State of . <br /> Minnesota,and certifies that all statements made on this application are,true and conect. <br /> ��� Date: �— 31— /� <br /> Applicant: <br />