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F SAC Charge(2016 Rate=$2,485.00) $ <br /> (SAC"Charge must acamrpauy all sr"cr pont applications unless prepind) <br /> ((Arno Cite Start can detctmunc it applicable) <br /> �lf not prepaid,a sc%cr connection permit will not be issued) <br /> Sewer Connection/Disconnect i Repair($50.00/Per Stull) S <br /> Pipe size inches;material Schd,10 air tested;. __cast iron <br /> 0 Water Connection/Disconnect/Repair($50.00/Per Stub) $� <br /> Ptpc sire mchcs;material Schd 40 air tested: copper <br /> 0 Water Availability For Future Hook-Up to Water(550.00) 5 <br /> Water Avuilabili(v Explanation: j <br /> I <br /> Contractor installed line to inside of house for future hook-tip <br /> This line will be inspected by the Public Works Department. t <br /> Required Before 'Vater Connection Permit is Issued: <br /> 1. Issue Water Meter&Horn Perrot <br /> .Any Additional Connection Fees Paid(If Applicable) <br /> � I <br /> Issue Water Connection Pcrmie <br /> 1. Collect Permit Fee&Issue Water Connection Permit <br /> ! I <br /> 1. SUBTOTAL of Permit Requested: $ �!/iyV <br /> 2. STATE SURCHARGE $ 1.00 <br /> 3. POSTAGE&HANDLING(Only on Mail-in Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $_v _aV <br /> ADDITIdNAh:WQRMATION-WATER METERS <br /> • WATER METERS must be picked up and paid for at Orono City Hall,these arc on a separate permit. <br /> • WATER METERS must be set and sealed by Orono Water Department (952)2494600, upon <br /> completion of meter 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 cer7= /Date: <br /> application are,true and correct. <br /> Applicant: _ <br /> w <br />