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. � <br /> � DETERMINING PERMIT FEES <br /> ❑ SAC Charge(2011 Rate=$2,230.00) $ <br /> (SAC Charge must accompany all sewer permit applications unless prepaid) <br /> (Orono City Staff can detcrmine if applicable) <br /> (If not prepaid, a se�ver connection permit will not be issued) <br /> [�Sewer Connection/Disconnect/Repair($50.00/Per Stub) $ <br /> Pipe size��" _inches; material�Schd 40 air tested; cast iron <br /> �'Watcr Connection/Disconnect/Repair($50.00/Per Stub) � <br /> Pipe sire__(_inclies; material X Sc�40 air tested; coppei- <br /> P� � <br /> ❑ Watcr Availability For Future Hook-Up to Water($50.00) $ <br /> Water Availabilitv Explanation: <br /> Contractor instalted line to inside of house for future hook-up. <br /> This linc will be inspected by the Public Works Department. <br /> Rcquired Before Water Connection Permit is Issucd: <br /> 1. Issue Water Meter&Horn Periuit <br /> 2. Any Additional Connection Fecs Paid(If Applicable) <br /> Issue Watcr Conncction Pcrmit: <br /> 1. Collcct Permit Fee&Issue Water Connection Permit <br /> 1. SUBTOTAL of Permit Requested: $ <br /> 2. STATE SURCHARGE $ 5.00 <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�nust be picked up and paid for at Orono City HaLI, these are on a separate permit. <br /> ■ WATER METEKS must be set and sealed by Orono Water Department (952) 249-4600, upon <br /> complction of'metcr installation. <br /> The undersigned hereby applies to the City of Orono far 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 statcinents made on this application are, true and correct. <br /> Applicant: Date: y� "'�g�� I <br /> Reset Form <br />