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1 , <br /> DETEIt1bIIlVIN�i PERMIT FEES <br /> ❑ SAC Charge(2015 Rate=$2,485.00) $ <br /> (SAC Charge must accompany all sewer permit applications unless prepaid) <br /> (Or o City Staff can determine if applicable) <br /> not prepaid,a se,wer�o nn ectic��permit will not be issued) <br /> Sewer Connection/D�necL-/-R�pair($50.00/Per Stub) $ <br /> Pipe size inches;material Schd 40 air tested; cast iron <br /> �}'�'Vater Connectio lDisconnect/Repair($50.00/Per Stub) $ <br /> Pipe size �ches;material Schd 40 air tested; copper <br /> ❑ Water Availability For Future Hook-Up to Water($50.00) $ <br /> Water Availabilitv Exalanation: <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 /> l. Issue Water Meter&Hom 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: $ <br /> 2. STATE SURCHARGE $ 1.00 <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 <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 s�arate 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 in strict accordance with the ordinances of the City and the regulations of the State of <br /> Minnesota, and certifies that all statements made on this application are,true and correct. <br /> ,�� '� j� <br /> �� � � � �����, <br /> A lican . � �C:�" � �' , � ..�t--� Date: � <br /> rr <br /> � � .�i� � � ,,���� <br /> �� � <br />