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t. ' L��'�:'E . . , ����R�TT F��" : <br /> �� �. f � <br /> � .. . <br /> ❑ SAC Charge(2013 Rate=$2,435.00) $ <br /> (SAC Charge must accompany all sewer permit applications unless prepaid) <br /> (Orono City Staff can determine if applicable) <br /> (lf not prepaid,a sewer connection permit will not be issued) <br /> �Sewer Connection isconnect/Repair($50.00/Per Stub) $ �� . � � <br /> Pipe size in erial Schd 40 air tested; cast iron <br /> ❑ Water Connection/Disconnect/Repair($50.00/Per Stub) $ <br /> Pipe size inches; material Schd 40 air tested; copper <br /> ❑ Water Availability For Future Hook-LJp to Water($50.00) $ <br /> Water Availabilitv Explanation: <br /> Contractor installed line to inside of house for future hook-up. <br /> This line will be inspected by the Public Works Department. <br /> Required Before Water Connection Permit is Issued: <br /> 1. Issue Water Meter&Horn Permit <br /> 2. Any Additional Connection Fees Paid(If Applicable) <br /> Issue Water Connection Permit: <br /> 1. Collect Permit Fee&Issue Water Connection Permit <br /> 1. SUBTOTAL of Permit Requested: $ "��' � n <br /> 2. STATE SURCHARGE $ 5.00 <br /> 3. POSTAGE&HANDLING (Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE (Add Lines I-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 /> ■ WATER METERS must be set and sealed by Orono Water Department (952) 249-4600, upon <br /> completion of ineter installation. <br /> The undersigned hereby applies to the City of Orono for issuance of a Utility Permit, agrees to do <br /> all work i��str`ict,accor.danc� with�hhe�ordinar�ces of.th•e City and the regulations of the State of <br /> Minnesota, and certifies that all state nts made on this application are,true and correct. <br /> . <br /> Applicant: Date: <br />