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, . � <br /> DETERMINING PERMIT FEES <br /> ❑ SAC Charge(2014 Rate=$2,485.00) � �— <br /> (SAC Charge n�ust accompany all sewei•pennit applications unless prepaid) <br /> (Orono Cit}� Staff can determine if applicable) <br /> (If not prepaid,a sewer connection permit�vill not be issued) <br /> ❑ Se«er Connec ion J llisconnect/Repair($50.00/Per Stub) $ <br /> Pipe size�inches;material SA�S�Schd 40 air tested: cast iron <br /> � <br /> ❑Water Connection/Disconnect/Repair($50.00/Per Stub) � <br /> Pipe size�i�icl�es;material C 9iX1p,cSchd 40 air tested; copper <br /> ❑ Water Availabilit,y For Future Hook-l;p to W'ater(550.00) $ <br /> Water Availabilitv Explanation: <br /> Contractor iustalled line to insidc orhouse for luture hook-up. <br /> This line will be inspected by ihe Public Works Depsrtmcnt. <br /> Required Before Vl'ater Conncction Pennit is Issued: <br /> 1. lssue Water Meter c� Horn Permit � <br /> 2. Any Additional Connection Fecs Paid(If Applicablcj <br /> Issuc Water Connection Permit: � <br /> 1. Collect Permit r'ee&lssue Water Connection Permit � <br /> 1. SUBTOTAL of Permit Requested: � O.o m <br /> ?. STATE SURCHARGE � 5.00 <br /> 3. POSTAGE&HANDLING(Only on Mail-ln Applications) $ 2.00 <br /> 4. T07'AL PERVIIT FEE(Add Lines l-3 .Abo��e) � 5.DO <br /> ADDITIONAL INFORMATION-WATER METERS <br /> ■ WATER:VIETERS must be picked up and paid for at Orono City Hall,thcse are on a separate permit. <br /> ■ VVATER nI1�:TERS must be set and sealed b�� Orono VVater Department (952) 249-4600, upon <br /> completion of ineter installation. <br /> The undersigned hereby applies to the City of Orono far issuance of a Utility Pennit, agrees to do <br /> all work in strict accordance with tlie ordinances of the City and the regulations of the State of <br /> Minnesota;and certifies that al] statements made on this application are, true and correct. <br /> Applicant: � � �c Datc: � / <br />