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� , <br /> DETERMIN(NG PERMIT FEES <br /> ❑S��C Ch:irge(201 G Ratc=$2,d85.q0) S <br /> (SAC Char�e must accompany all se�aer permit appiications unless prepaid) <br /> (Orono City Stnf�'can determinc if�applicable) <br /> (If not prepaid,a se�ver connection per►nit��ili not be issued) <br /> �Sewer C:onnection/Uisconnect/Repnir(SSQ.00/Per Stub) S �l 1�O�� <br /> �� Pipe size inches:materill Schd 40 air tested; cast iron <br /> ❑�ti'�ter Connection/Disconnect/Rep:iir($SQ,00/1'er Stub) $ <br /> Pipe size inches;material Schd 40 air tested; copper <br /> ❑�V;itcr Av�il:�bility �or Puturc llool:-Up to W.itcr(�SOAO) � _ <br /> �Vater Avail.ihilitv Exnlanation: <br /> Contractor installed line to inside of house for future hook-up. <br /> This line will bc inspecte�i by the Public Works Department. <br /> Required t3cforc W�tcr Connection Pennit is Issued: <br /> 1. Issue�'Vater Nleter& Horn Permit <br /> 2. Any Additinnal Connection Pees Paid(If Applicable) <br /> Issue�Vater Connection Pcnnit: <br /> 1. Collect Permit Pee& Issue�Vatcr Connection Permit <br /> l. Slti3T0'T'AL of Permit Requcsted: 5����.-S.l`—'— <br /> 2. STAT'E SURCHAIZGG S_ �.�0_ <br /> 3. POSTAGE�� NANDLII�G(Only on Mail-In Applications) � _2.00 <br /> 4. TOTAL,PER�it'C F'EE(Add Lines 1-3 Above) 5 ��, Q lJ <br /> ADDITIONAL INr01tM�1TION —WATE{2 METE�RS <br /> ■ WATER NIE"TGI25 must bc picked up and paid for at Orono City Hall,these are on a sen�rate permit. <br /> • �VATER VI�'I'ERS must bc set �nd sealed by Orono �Vater Department (952) 249-4G0(l, upon <br /> completion of ineter installation. <br /> Thc undcrsi�ned hereby applies to the City of Oronc� for issu�ince of a Utility Permit,agrees to do <br /> all �vark in striet aecordance with the ordinances of the City and the regulations of tl�e State of <br /> Minnesota. and certifies that��II statements madc on this application are, true and correct. <br /> Applicar : Date:�� ( <br />