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. ,l, <br /> DETERMINING PERMIT FEES � � � <br /> �SAC Charge(2010 Rate=$2,100.00) $ � � �/�� � <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 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 Explanation: <br /> Contractor installed line to inside of house for future hook-up. <br /> This line will be inspected by the Public Works Department. <br /> Required Before Water Connection Permit is Issued: <br /> l. Issue Water Meter& Horn Permit <br /> 2. Any Additional Connection Fees Paid(If Applicable) <br /> Issue Water Connection Permit: <br /> L Collect Permit Fee&Issue Water Connection Permit <br /> l. SUBTOTAL of Permit Requested: $ .�d � � � <br /> 2. STATE SURCHARGE $ .50 <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 _ <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ ��� � <br /> ADDITIONAL INFORMATION-Vt�ATER METERS <br /> ■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a senarate�ermit. <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 str'c accordance with the ordinances of the City and the regulations of the State ofi <br /> Minnesota, an�c rtifie that all state ents made on this application are,true and correct. <br /> Applicant: Date: ��� � I " <br /> Rese Form <br />