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,+ � � , <br /> DETERMlN1NG PERMIT FEES <br /> ❑ SAC Charge(2015 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 /> ❑ Sewer Connection/Disconnect/Repair($50.00/Per Stub) $ <br /> Pipe size inches;matenal Schd 40 air tested; cast iron <br /> ❑Water Connection/Disconnect/Repair($50.00lPer Stub) $ <br /> Pipe size inches;material Schd 40 air tested; copper <br /> � <br /> ❑Water Availability For Future Hook-Up to Water($50.00) $ <br /> Water Availabiliri Exulanation: � <br /> Contractor installed line to inside of house for future hook-up. � <br /> This line will be inspected by the Public Works Department. �L:� v <br /> Required Before Water Connection Permit is Issued: <br /> l. Issue W ater Meter&Horn Permit c <br /> 2. Any Additional Connection Fees Paid(If Applicable) � , <br /> Issue Water Connecrion Permit: <br /> 1. Collect Permit Fee&Issue Water Connecrion Permit <br /> � , <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 1-3 Above) $ <br /> ADDITIONAL INFORMATION—WATER METERS <br /> ❑ WATER METERS must be picked up and paid for at Orono City Hall,these are on a separate permit. <br /> I_1 WATER METERS must be set and sealed by Orono Water Department (952) 249-4600, upon <br /> completion of ineter installafion. <br /> The undersigned hereby applies to the City of Orono for issuance of a Utility Permit, agrees to do <br /> all work in strict acco an e with the ordinances of the City and the regulations of the tate of <br /> Minnesota,and c all statements made on this application are,true and orrect. <br /> A licant: Date: �/ � �� <br /> PP <br />