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From: OB/20/2015 10:49 #797 P.003/003 <br /> ;_._DETERMINiNG PERMIT�E�S -- ___� <br /> ❑SAC Charge(2015 Rate=�2,485.00) $ <br /> (SAC Charge must accompany all sewer permit apnEications unless prepaid) <br /> (Orono City Staff can determine if app]icable) <br /> (If not prepaid,a sewer connection permit w�ill not be issued) <br /> �Sewer Connection/Disconnect/Repair($50.00/Per Stub) $ <br /> S� �0 <br /> Pipe size inches;material Schd 40 air tested; cast�ron <br /> ❑Water Connection/Disconnect/Repair(�50.00/I'ei•Stub) $ <br /> Pipe size inches;material Schd 40 air tested;____ copper <br /> ❑Water Avaiiability For Future Hook-Up to�'ater($50.00) $ <br /> V1'ater Availabiiiri Exptanation: <br /> Contractor instalfed tine to inside ofhouse for future hook-up. <br /> This line will be inspected by the Public�'orks Department. <br /> Required Before Water Connection Permit is tssued: <br /> 1. lssue Water Meter& Hom Permit ^ <br /> 2. Any Additional Connection Fees Paid(If App(icable) <br /> Issue Water Connection Permit <br /> L Collect Permit Fee&Issue Water Connection Permit <br /> I. SUBTOTAL of Permit Requested: $ 50. �v <br /> 2. STATE SURCHARGE $ 1 00 �.c' <br /> �11.1+� <br /> 3. POS"1'AUE&HANDLIN('�{Only on Mail-In Applications) $_ �_._�.�ti�� <br /> 4. TOTAL PERl�11T 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 /> ■ WATFR METEI7S must be set and sealed by Orono Water Departme��t (9S2) 249-4600, upon <br /> comp{etion of ineter installation. <br /> The undersigned hereby applies to the City of nrono for issuance of a Utility Permit, agrees to do <br /> all ��ork 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 tlais applicatian are, true and correct. <br /> Appl�cant: Date: (�1� �Z� !Z-�f.� <br />