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r ' <br /> DETERMINING PERMIT FEES <br /> ❑SAC Charge(2014 Rate=$2,485.00) $ <br /> (SAC Chaige must accompauy all scwer permit applications imless prepaid) <br /> (Orouo City Staff can determine if applicable) <br /> (If not prepaid,a sewer connection permit will not be issued) <br /> � Sewer Connection/Disconnect/Repair($50.00/Per Stub) $ <br /> Pipe size inches; n�aterial Schd 40 air tested; cast iron <br /> [�Water Connection/Disconnect/Repair($50.00/Per Stub) $ <br /> Pipe size inchcs; material Scl�d 40 air tested; copper <br /> ❑ Water Availability For Future Hook-Up 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 Pennit is Issued: <br /> 1. Issue Water Meter&Honi Pernut <br /> 2. Any Additional Connectio�i Fees Paid(If Applicable) <br /> Issue Water Connection Permir. <br /> 1. Collect Permit Fee&Issue Water Connection Permit <br /> 1. SUBTOTAL of Permit Requested: � <br /> 2. STATE SURCHARGE $ 5.00 <br /> 3. POSTAGE&HANDLWG(Only on Mail-In Applications) � 2.��� <br /> 4. TOTAL PERMIT FEE (Add Lines 1-3 Above) $ <br /> ADDITIONAL INFORMATION—WATER METERS <br /> ■ WATER METERS u�ust be picked up ancl paid for at Orono City Hall,these are on a separate pennit. <br /> ■ W'ATER METERS must be set and sealed by Orono Watcr Department (952) 249-46U0, 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 in strict accordance with the ardinances of the City and the regulations of the State of <br /> Minnesota, and certifies that all statements made on this application are, true and con�ect. <br /> Applica Date: L �/Lj�L/ <br />