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� � � <br /> 1 <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 /> �Sewer Connection/Disconnect/ e,J ai ($50.00/Per Stub) $ <br /> Pipe size�inches;material���-�".,hd 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 /> ❑Water Availability For Future Hook-Up to Water($50.00) $ <br /> Water Availabilitv Exulanation: <br /> Contractor installed line to inside of house for future hook-up. <br /> This line will be inspected by the Public Works Department. <br /> Reauired Before Water Connection Permit is Issued: <br /> . 1. Issue Water Meter&Horn Permit <br /> 2. Any Addirional Connectiori Fees Paid(If Applicable) <br /> Issue Water Connection Permit: <br /> 1. Collect Permit Fee&Issue Water Connection Pemut <br /> 1. SUBTOTAL of Permit Requested: $ <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 /> �ALDD�TIO'�AL'I�0 �'�3 l�T--��VATER°�N�ETE�S , <br /> k s <br /> �. �. - . ,° �. ,: <br /> ■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a senarate Qernut. <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 sh-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 /> � ^ / <br /> Applicant: Date: _�� r ! � <br />