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,►. . ;� <br /> D�T�RI�+�t#PEI�I`�'FE� <br /> ❑ SAC Charge(2015 Rste=52,485.00) $ <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 /> ❑ Sewer Connection/Disconnect/Repair(550.00/Per Stuti) $ <br /> Pipe size inches;material Schd 40 air tested; cast iron <br /> ❑Water Conaection/Disconnect/Repair($50.0(I/Per Stub) $ <br /> Pipe size inches;material Schd 40 air tested; copper <br /> []Water Availability For Future Hook-Up to Water(550.00) $ <br /> Water Availabiliri Eznlanation: <br /> Contractor installed line to inside of house for future hook-up. <br /> This line will be inspected by the Public Works Department. � <br /> R uired Before Water Connection Permit is Issued: <br /> ]. Issue Water Meter&Hom Permit <br /> 2. Any Additional Connection Fees Paid(If Applicabie) <br /> Issue Water Connecrion Permit: <br /> 1. Collect Permit Fee&Issue Water Connection Permit <br /> 1. SUBTOTAL of Permit Requested: $ <br /> 2. STATE SURCHARGE $ 1.00 <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines l-3 Above) $ <br /> A.DDITIONAL INFORMATiON-WATER 1�IETERS <br /> ■ WATER METERS must be picked up and paid for at Orono Ciry Hall,these are on a sevarate permit. <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 f issuance of a Utility Permit, agrees to do <br /> all work in strict accordance with th rdinances o e City and the regulations of the State of <br /> Minnesota, and certifies that all s ments made is ap ication are,true and correct. <br /> Applicant: <br /> Date: � ' � � � r / � <br />