Laserfiche WebLink
NOU-•1Gz2011 (MON) 12; Q2 Final Grade In� (FAK)952a925101 P. 0031003 <br /> ,-y; � �rc:. ' ' .+Ikf i ,; . <br /> , rw� � . _ .i' ..+.�..r <br /> x F •�i,:. ��'.;� .r: .,o. '.., ., � . ip; t."�::;a '�r.,. <br /> , a<i <br /> ... ,.r «}y.:,.,> . C•',... . .� .�.'�';i';'D'r '?S��'i ��I'.`"i,_;�F'�....:. :t" <br /> a. <br /> �i;�� - �:. <br /> .. . i� � . �� . �.: . .. ,.'�� <br /> ; <br /> • <br /> � �. } . .. .�. <br /> ,. <br /> . <br /> . . . .. . . .. .. . .'�, � � , , -: �, i. <br /> 'i..' ' <br /> , . . , a� <br /> . .. . . .. . . - ,.. ......:, T <br /> ❑SAC ChArge(Z011 Ilatc=$2,23U.DU) S <br /> (SAC Ch�t'ge muet accompany alf sewer permit applicalions unless prepaid) <br /> (Orono City Starf can determinc if applicable) <br /> (If not prepald,a eewer connection permit wi{1 not be isRued) <br /> �■ Sewer Connectlon/Dlsconnect/Repair($50.00/Per Stub) $50.00 <br /> Pipe size ��' inches;material Sehd 40 air tcstcd; cast iron <br /> �Weter Connection/Ulsconnect/IZepalt'($50.(111/Per Stub) $50.00 <br /> Pipe size I� inches; mscerial Sehd 4U air cested; eopper <br /> ❑Water Aveila�ility F`or Future Houk-Up to Wate�'(SSU,UO) $ <br /> Wuter Aveilabilitv Exolanetion: <br /> ConcrActor installcd line to inside of house for future hook-ttp, <br /> This line w111 bc inspccted by the Public Warks Deparcment. <br /> $gqlAit�d DePore Watcr Connection PermiC is Jssued: <br /> l, lesue Water Mcter& Horn Permit <br /> 2. Any Addtlional Conncction Fees Paid(If Applicabfe) <br /> lssue Wa�er CQnnection Pcrmit: <br /> l, Collcet Pcrmit Fee&lssue Water Conneclion Permit <br /> I. SUBTOTAL of f�ermit Requested: $100.OD <br /> 2. STATG SURCHARG� $ 5.00 <br /> 3. PpSTAGE&HANDL,INCl(Only on Mail-In Applications) $ 2.D0 <br /> 4. TOTAL PERMIT FF,E(Add Lines 1-3 Above) $ 105.00 <br /> ADDITTONAL.INFORMATION`-WATER METERS <br /> • WATFR ME'fER5 muet be picked up and paid for at Orono City Hall,these are on a senarate permit. <br /> � WA,TER METERS muet be eet and sealed by Orono Water Depsrtment (95Z) 249-4600, upon <br /> completion of ineter Installation. <br /> The undersigned hereby applies to the City of Orono for issuance of a Utility P�nncait, agrees to do <br /> all work in etrict accordance with rhe ordin,ances of tlie City and tlie regulations of.tlle State of <br /> Mionesota,And certifies that all atatements inade oa this application are, true and correct. <br /> Applicant• �..!�,�9� '� � �'" Date: � � � �� <br /> �� �I ,�.rd;I..� <br />