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DETERMINING PERMIT FEES <br /> ❑SAC Charge(2015 Rate=$2,485.00) $ <br /> (5AC Charge must accompany all sewer permit applications unless prepaid) <br /> (Orono Ciry Staff can determine if applicable) <br /> (If not prepaid,a sewer connection permit will not be issued) <br /> �Sewer Connection isconnec /Repair($50.00/Per Stub) $ �U � <br /> Pipe size�inc i , enal �c- 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 Warks Department. <br /> Required Sefore Water Cotuiection Pennit is Issued: <br /> 1. 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 Water Connection Permit <br /> S� __° <br /> 1. SUBTOTAL of Permit Reyuested: $ <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) $ 7 � ' <br /> ADDITIONAL INFORMATION-WATER METERS <br /> • WATER ME'CERS must be picked up and paid for at Orono City Hall,these are on a separate pernut. <br /> ■ WATF,R MFTERS must be set and sealed by Orono Water Department (952) 249-4600, upon <br /> completion of ineter instaltation. <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 certifies that all statements mad�on this application are,true and correct. <br /> �-- I o <br /> A licant: � Date: � 2 �r <br /> PP <br />