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DETERMINING PERMIT FEES <br /> ❑SAC Charge(2012 Rate=$2,365.00) $ <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 /> �_. <br /> � Sewer Connectio /Disco� nn—e� epair($50.00/Per Stub) $ �J� <br /> Pipe size inches;material Schd 40 air tested; cast iron <br /> �.,;_. <br /> �Water Connectio Dis��—conn t/Repair($50.00/Per Stub) $ �� <br /> Pipe size i r�al Schd 40 air tested; copper <br /> ❑Water Availability For Futur�Hook-Up to Water($50.001 $ <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 /> l. 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 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 /> L=i <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ !D 1 <br /> ADDITIONAL INFORMATION— WATER METERS � <br /> ■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a se�arate 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 strict accordance with the ordinances of the City and the regulations of the State of <br /> Minnesota, and e�ifies th al'�statements made on this application are,true and correct. <br /> Applicant: Date: G—' �' 0 � <br /> Reset Form <br />