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DETERMINING PERMIT FEES <br /> ❑ SAC Charge(2016 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 /> f , <br /> ❑ Sewer Connection/Disconnect/Repair($50.00/Per Stub) $ �� <br /> Pipe size inches;material Schd 40 air tested; cast iron <br /> ''i <br /> i �L <br /> �j C <br /> ❑Water Connection/Disconnect/Repair($50.00/Per Stub) $ , <br /> Pipe size inches;material Schd 40 air tested; copper � <br /> . �� ,� <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 Deparhnent. <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 /> , ��' <br /> 1. SUBTOTAL of Permit Requested: $ i�'�� <br /> 2. STATE SURCHARGE $ 1.00 <br /> 3. POSTAGE&HANDLING(Only on Mail-in Applications) $ _�r.fl0 <br /> / ��, <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 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 seated 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 in strict accordance with the ordinances of the City and the regulations of the State of <br /> Minnesota, and certifies tt�at all statements made on this application are,true and correct. <br /> Applicant:�{�„� ' � Date: 1 '\�— \(p <br />