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•+► <br /> DETERMINING PERMIT FEES <br /> ❑ SAC Charge(2011 Rate=$2,230.00) $ <br /> (SAC Charge must accompany all se�ver 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 /> [� Sewer Connec 'on/ Disconnect/Repair($50.00/Per Stub) $ <br /> Pipe size�inches;material Schd 40 air tested; cast iron <br /> Water Connection/Disconnect/Repair($50.00/Per Stub) $ <br /> � Pipe size inches;material Schd 40 air tested; copper <br /> � <br /> ❑ Water Availabilit�� For Future Hook-Up to VVater($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 Department. <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 Peimit <br /> 1. SUBTOTAL of Permit Requested: $ <br /> 2. STATE SURCHARGE $ 5.00 <br /> 3. POSTAGE& HANDLWG(Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PER1�11T FEE(Add Lines 1-3 Above) $ <br /> ADDITIONAL INFORMATION —WATER METERS <br /> ■ WATER��1ETERS must be picked up and paid for at Orono City Hall,these are on a separate permit. <br /> ■ WA7'ER MGTERS 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 Pernlit, 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 state e s made on this application are, true and correct. <br /> � i <br /> / <br /> s � <br /> Applicant: Date: <br />