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.r • <br /> DETERMINING PERMIT FEE5 <br /> ❑ SAC Charge(2016 Rate=$2,485.00)' $ <br /> (SAC Charge must accompany all sewer 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 Connection/Disconnect/Repair($50.00/Per Stub) $ 50.00 <br /> Pipe size 4 inches;materialendo pu�aSchd 40 air tested; cast iron <br /> ❑ Water Connection/Disconnect/Repair($50.00/Per Stub) $ 50.00 <br /> Pipe size 1 inches;material PVC Schd 40 air tested; copper <br /> ❑ Water Availability For Future Hook-Up to Water($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 Warks Department. <br /> Required Before Water Connection Permit is Issued: <br /> l. Issue Water Meter& Horn Permit <br /> 2. Any Additional Connection Fees Paid(IfApplicable) <br /> [ssue Water Connection Permit: <br /> 1. Collect Permit Fee& Issue Water Connection Permit <br /> I. SUBTOTAL of Permit Requested: $ �00.00 <br /> 2. STATE SURCHARGE $ 1.00 <br /> 3. POSTAGE& HANDL[NG(Only on Mail-In Applications) $ . <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ 101.00 <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 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 Permit, agrees to do <br /> all work in sU-ict 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: 2-13-17 <br />