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Feb.26.2015 12 :28 PM PAGE. 2/ 2 <br /> DETERLVIINING PERMIT FEES <br /> C]SA.0 C�arge(2Q15 Rnte=�2,A8S.�0) � <br /> (S.AC Charge must accompany all sewei�peri�iit applications u�tle s prepaid) <br /> (Urono City StafPcttn determine iFapplicable) <br /> (If not prep�id,H sewer connection permit will not be issued) <br /> �ewer Conuectioa/Aisco�mect/�epair(550.00/Per Str�b) �. �•-� <br /> Pipe siz�,,,,._,�"!„inches;materiai,,,�,,Schd QU air tested; cast iron <br /> �'Water Co�nne�tion/Disconuect/Rgpai�•(�50,00/Pcx Stub) $__��•��___.....,, <br /> Pipe size.._�_inclies;�nace�•ial�r,�'��eSclid 40 air tesced;_ _._ opper <br /> rv_!��►�S <br /> �,]Water Availability For Futu�•e Hook-Up to Wa#er($50.00) $ <br /> ter Av j�ailiiv E�culanntian: T�� <br /> Contractor installed line to inside of house for future hook-up. <br /> This lirae will be inspected by t)�e�ublic Works Ueparcnaexa�, <br /> Rec�ired BefoCe Water Conneckion Permit is Issued: <br /> I. Issue Water Matar&Horn Permit <br /> 2, Any Additional Connection Fees Paid(if Applicable) <br /> �ssiie tea r C'o:necti�, on 1'ermi�: <br /> 1. Collect Permit ree&Issue Water Connection Pern�it <br /> 1. Si3STOTAL of Permit Reque�ted: $ 1�•� <br /> 2, STATE SZ:'RCHARQE $ 5.00 <br /> 3, POS`1"�1GE&I-iANnI,ING(Only on M�il.-Tn�ppl�cations) � 2,UU.....__,_„_ <br /> 4. TOTAL PERMl"f�"�:�(Add L,ines 1-3 Above) � `(�7�l'� <br /> ADDITIpN,�1L INFpRMATION-�WATER TERS <br /> ■ WATEIi METERS must be picked up and paid for at Orono City Hali,th e are on a senarAte pern�it. <br /> • WATER IVt�TERS must be set nnd sexled by Orono W�ter Depa�'t �ent (952) 2�J9-4640, upon <br /> rompletion of ineter inst�llation. <br /> The undersigned hereby �tpplies to the City of Orono for issue3nce of a ility Permit,agrees to do <br /> at] �wprk in sd'ict accordance with the ordinances of the City and the r g�l&tions af die Stafo of <br /> Minnesota,and certi�es that all stxtements made on this applicatzon are,true and correct, <br /> Applicant; ,._..._.......�..,�,.�.._........._..W...._.�...._..,.,....._.._..._. Date, r��r- �S <br />