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� Jun 09 14 11:18a Westonka Mechanical 952-472-4961 p.2 <br /> [� ' _ ' > DETER1�fININGPERI4�ITFEES `` _ - <br /> ❑SAC Charge(2014 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 /> ❑Sewcr Connection i Disconnect 1 Repair(S5a.00lPer Stub) $_�CJV[J'`_ <br /> Pipe size�mc�s��i��Schd 40 air tested; cast iron <br /> •�f',� ! i <br /> Gr" <br /> ❑Water Conuection/Discannect/Repair(554.00/Per Stub) $ <br /> Pipe size inches;material Schd 40 air tested; copper <br /> ❑Water Availability For Futurc Hook-Up to VVater($50.00) S <br /> 1Vater Availability Exp[anation: <br /> Concractor installed line to inside vf house for future hook-up. <br /> This]ine will be inspected by the Public Works Department. <br /> Reauired Befare W'ater Connection L'ermit is Issued: <br /> ]. Issue Water Meter&Horn Permit <br /> 2. Any Additional Connection Fees Paid(If Applicable) <br /> Issue Water Connection Permit: <br /> 1. Collect Permit Fee&Issue l�'ater Conneetion Permit <br /> 1. SUBTOTAL of Permit Requested: $ �(1� <br /> 2. STATE SURCHARGE $ 5.00 <br /> 3. POSTAGE&HAI�TDLING(Only on]V1ail-In Applications) S 2.00 <br /> �� <br /> 4. TOTAL PERMIT FEE{Add Lines 1-3 Above) S ' <br /> ADDITIO�I,AL 1NFORMATTON—WATER METERS <br /> ■ WATER ME7'ERS must be picked up and paid for at Orono City Hall,these are on a se�aratc vermit. <br /> ■ WATER ME7'ERS rnust be set and sealed by Orono VVater Department(952) 249�600, upon <br /> completion of ineter iastallation. <br /> �'he undersigned hereby applies to the City of Orono for issuance of a Utility Permit,agrees to do <br /> a11 wori� in strict accordance Lvith the ordinances of th� City and the regulations of the State of <br /> Minnesota, and certifies that alf statements made on this application are,true and correct. <br /> Applicant: ,.�ZL�, ���1� Date: ���,� <br />