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Apr-11-2011 08:48am From-CITY OF ORONO +9522494616 T-511 P.UO2/002 F-365 <br /> , , <br /> i ���, <br /> ❑SAC CharEe(2012 R,stte=52,36�.04) � <br /> {SAC Chacge must accompany all sewer permit appliea�ions uniess prepaid f <br /> (Orono Ciry Staff can detcnnine if applicable) <br /> (If not prapoid,A sewer connection p�rmit wiU not be issued) <br /> �Q Sewer Connection/Discoanect/Repair(SSO.o0/Per Stub) S <br /> Pipe sizc�inches;material��Schd 40 air tesied; _cast iron <br /> (�VVater Connection!Diseonnect/ pair{550.04/Per Stub) $ _ <br /> Pipe size �� inches;material�Schd 40 air tested; copper <br /> ❑R�'uter A��ailability T�or X'uture�ook-Lp to V1'ater(550.40) $ <br /> Wate_r_.�vnilnhiliLY Rfi)IAilAf100 t <br /> Conasetor installed linc to inside of house for future hook-up. <br /> This line will be insp�cted by the Public Works Deparunent, <br /> Required Befare VJater Connection Parmit is Issued; <br /> 1. Issue Water Meter&Hom Permit <br /> 2. Any Additiona!Connection Fees Paid(If ApplicAble) <br /> Issue Water Coanecuon'Permit: <br /> 1. Collecc Pernut Fee&Issue Water Connection Permit <br /> 1. S�BTOTAI,af Permit Requested: $ .. <br /> 2. STAT'E S[TRCHARGP $ 5.00 <br /> 3. POSTAGE&HAIv'DLING(Only on Mail-In Applications) $ 2.00 <br /> 4. TOT�1L PTR111I'T F�E(Add Lines 1-3 Above) S <br /> Al7'DT'I'TONAL TN�'ORMATION�WATER M�'�ERS � . <br /> ■ WAT�R ME f�125 must be picked up and paid for at 4rono Ciry Hall,chesc are on a senarate nPrmlt. <br /> � R'ATER METEI2S n�ust be set And sealed by Orono WAter DepArtment {952) 249-4600, upon <br /> completion of ineter inst�Uatio�. <br /> The undersigned hereby applies to the Ciry of Orono �or issuance of a Utiliry permit,agrecs to do <br /> all work in strict accordance wich the ordinances of th� City and tl�e regularions of the State of <br /> Minnesota, and certifies that all statements made on this applicarion are,mte and corrr,ct. <br /> /' -� <br /> Applicant: �*e ����'� l�atr: � <br />