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T �. <br /> ❑SAC Charge(2010 Rate=$2,100.00) $ �/�' � <br /> (SAC Chazge 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 Connection/Disconnect/Repair($50.00/Per Stub) $ ��' �� <br /> Pipe size inches;material 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 Availabilitv Exalanation: <br /> Contractor installed line to inside of house for future hook-up. <br /> This line will be inspected by the Public Works Deparhnent. <br /> Required Before Water Connection Permit is Issued: <br /> 1. Issue Water Meter&Horn Permit <br /> 2. Any Addirional 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: $ (�.l�� �� <br /> 2. STATE SURCHARGE $ 5.00 <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ .�90 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ O��S,S,�� <br /> 3 � �: , � Ai)I3I'TI�AT�AL T�T�()RN1�AT��1=31�-�A"�i�i�#ETERS <br /> ■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a senarate nermit. <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 Pernut, 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 correct. <br /> Applicant: �- � Date: ,� �-- � �'-1� <br />