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Feb 10 16 10:31 a Metro General 7634282968 p.2 <br /> DETERMINING PERMIT FEES <br /> ❑ SAC Cha rge(2016 Rate=$2,485.00) $ <br /> (SAC Charge must accompany al1 sewer permit applications unless prepaid) <br /> (Orono Ci[y Staffcan determine ifapplicable) <br /> (3f not prepaid,a seh�er connection permit will not be issued) <br /> �ewer Conuection I Disconnect/Repair($50.00fPer Stub) $ ;.1� <br /> p�p�S9� !�. _inches;materia] ✓ Schd 40 air tested; cast iron <br /> �]Water Connection�'Disconnect/Repair{�SO.00/Per Stub) $ <br /> Pipe size inches;material�__Schd 40 air tested;__`copper <br /> ❑Watcr Availability For Future Hook-Up to Water($50.00) $ — <br /> Water Availabiti Ex lanation: � <br /> Contractor installed line to inside of house for future hook-up_ <br /> This line will be inspected by the Public 4Vorks Department. <br /> Required Before VJater Connection Pennit is lssued: <br /> 1. Issue 11+'ater Ivleter&[�om Perrnit <br /> 2. Any Additional Connection Fees Paid(]f Applicabje) <br /> Issue VVater Cannection Permit: <br /> L Collect Permit Fee& lssue Water Connection Permit <br /> 1. SUBTOTAL of Fermit Reguested_ $ —%�� <br /> 2. STATE SURCHARGE � 1.00 <br /> 3. POST.�GE& HANQL(NG(Only on Mail-In AppSications) $_ 2•�� <br /> 4. TOTAL PERMIT FEE{Ad�Lines 1-3 Above) $ ' " `" <br /> ADDITTONAL INFORMATION— W A'FER METERS <br /> • 1�'ATER METERS must be picked up and paid for at Orono City Hall,These are on a se arate ermit. <br /> ■ N�'ATER METERS must be set and sealed by Orono �'Vater De�artment (952) 249-a6130, upon <br /> completion ot�neter inslallation. <br /> The undersigned hereby applies to the City of Orono for issuance of a Utiiity Permit, agrees to do <br /> all wor;c in strict accordance with the ordinances of the CiEy and the regulations of t�ie State of <br /> Minnesota,and certifies that all statements made on this application are,true and correct. <br /> Date: ` �� <br /> Applicant: — <br />