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s , <br /> r <br /> DETER1vIINI1�TG PERMIT FEES <br /> ❑SAC C6arge(2014 Rate=$2,485.00) S <br /> (SAC Charge must accompany alI sewer pennit applications untess prepaid) <br /> (Orono City Staff can detennine if applicable) <br /> (If not pcepaid,a sQwer conne.ction permit h�ill not be issued) <br /> �Sewer Connection/Disconaect/Repa'r(550.00/Per Stab) S <br /> Pipe size�inches;mate�riaNl��chd 40 air tested; cast iron <br /> `C�'` <br /> �WAter Conn tion/Discounect/Repai�•,($50.00/Per Stub) $ <br /> Pipe size � uiches;material�V�Schd 40 au•tested: copper <br /> ,�r,�.� . <br /> ❑Watec Availxbility�'or Future Hook-Up to Water(S50.00) $ <br /> � wA�PI'AYAtIAUII�fV EXP�AOA11011: � <br /> j <br /> Conh•actor installed line to inside of house for fuh►re hook-up. <br /> This line��ill be inspected by the Public Works Department. <br /> Requu�ed Befoce Water Connectio�i Peiniit is Issued: <br /> 1. Issue Water Meter&Horn Perntit <br /> 2. Any Additioiial Cocu�ectioii Fees Paid(If Applicable) � <br /> Issue Water Connection Perniit: <br /> 1. Coliect Perrnit Fee&Issue Water Connection Pennit <br /> 1. SCBTOTAL of Pennit Requested: $ <br /> 2. STATE SURCHARGE $ 5.00 <br /> 3. POSTAGE&HANDLING(Only on Mail-Iii Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE(Add L'nies 1-3 Abo�e) S <br /> � ADDITIONAL INF�RMATION—WATER METERS <br /> ■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a separate uennit. <br /> • WATER METERS �nust be set and seAled by Oi�ouo Water Depxitment (952) 249-4600, upou <br /> completiou of inetei'�llStRIIA[�011. <br /> The undersigned hrreby applics to thc City vf Orono for issuance of a ti tility Pennit, agrees to do <br /> all work in strict accordance with the ordinances of tl�e City and tl�e regulations of the State of <br /> Miimesota, azid certifies that all st�teuieuts rnade on tlus application are,hue uid conect. <br /> . <br /> �". <br /> Applicant: � Date: <{-17-�1� <br />