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r <br /> DETERMINING PERMIT FEES <br /> ❑ SAC Charge(2013 Rate=$2,435.00) � <br /> (SAC Charge must accompany all sewer pernut appiications unless prepaid) <br /> (Orono Ciry Staff can deterniine if applicable) <br /> (If not prepaid,a sewer connection permit will not be issued) 4 <br /> �Sewer Con tion/Disconnect/Repair($50.00/Per Stub) $ � `/ <br /> Pipe size�inches;material Schd 40 air tested; cast iron <br /> ❑ Water Connecfion/Disconnect/Repair(�50.00/Per Stub) $ <br /> Pipe size inches;material Schd 40 air tested; copper <br /> ❑ Water Availability For Future Hook-Up to Water($50.00) $ <br /> Water A�-ailabiGtv Exnlanation: <br /> Contractor installed line to inside of house for future hook-up. <br /> This line will be inspected by the Public Works Deparnnent. <br /> ReQuired Before Water Connection Permit is Issued: <br /> 1. Issue Water Meter&Horn Pernut <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 Pennit Requested: S <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 must be picked up and paid for at Orono City Hall,these are on a separate permit. <br /> • WATER METERS must be set and sealed by Orono Water Departmer►t (952) 249-4600, upon <br /> complerion 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 /> Applicant: _ Date: � � <br />