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DETERMINING PERMIT FEES <br /> ❑ SAC Charge(2015 Rate=$2,485.00) $ <br /> (SAC Charge must accompany all sewer permit applications unless prepaid) <br /> (Orono City Staff can determine if applicable) <br /> (If not prepaid,a sewer connection permit will not be issued) <br /> (�Sewe Connection Disconnect/Repair($50.00/Per Stub) $ ��' � _ <br /> Pipe s�ze 'Iches;material Schd 40 air tested; cast iron <br /> i <br /> � i (�� .s ys+� <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-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 Permit is Issued: <br /> 1. Issue Water Meter&Horn Permit <br /> 2. Any Additional Connection Fees Paid(]f Applicable) <br /> Issue Water Connection Permit: <br /> l. Collect Permit Fee& [ssue Water Connection Permit <br /> l. SUBTOTAL of Pennit Requested: $ �w '� _ <br /> 2. STATE SURCHARGE $ 5.00 <br /> 3. POSTAGE& HANDLING (Only on Mail-In Applications) $ ��1� <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ / U�� <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 /> 7�he Lindersigned hereby applies to the City of Orono for issuance of a Utility Permit, agrees to do <br /> all work in strict accordance with the ordi�lauces of the City and tl�e regulations of the State of <br /> Minnesota, and certifies that all statements made on this application are, true and correct. <br /> Applicant: ` Date: �/ —/ �' �J <br />