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05/23/17 07:39 OLSONCONSTRUCTION 9524485289 p.03 <br /> rfl�{y�{'°r*}A'� t�Gc7,4..�'�,,�fFsy rr;1t:S'�) �fu� .'. -,. ,.. • . .� � '�s t {r:. v�t il 1ti! �'� t3Y.�1�j��roq�.z7 n�.;i:� <br /> ,4�-r,,�..,���� .;.:d"n`,�1 ,tr t.-� �n., i•>�,�s�,� .;_� �. .�.'; �' �� f �...'.. . �'�,: ii..i"�y�'A,fi��,t�lt��y�i3rlu���",��y,�4;,'�4,�T����k��5��,1��- <br /> ❑SAC Charge(Z016 Rate=52,485.00) $ <br /> (SAC Charge must accompany ali sewer permit applications unless prepaid) <br /> (Orono City Staffcar►determine if applicable} <br /> (If not prepaid,a sewer connection permit will not be issued) <br /> �Sewer Connection isconnect Repair($50.00/1'er Stub) $ y���� <br /> Pipe size inc es;ma enal Schd 40 air tested;_.___cast iron <br /> �Water Conaection Disconnec 1 Repair($50.00/Per Stnb) $ ���� <br /> Pipe size inc es; nal Schd 40 air tested;_. copper <br /> ❑Water Avaitability For Future Haok-Up to Water($50.00) $ ___ T <br /> Water Availabilitv Exnlanatioo: <br /> Contractor installed Eine to inside of house for future hook-ug. <br /> This line witl be inspected by the Public Works Department. <br /> R�e uired Before Wat�r CQnnection Permit is Issued: <br /> l. Tssue Water Meter 8z.Horn Permit <br /> 2. Any Additional Connection�ees Paid(If Applicable) <br /> Issue Water Conaection Permit: <br /> i. Collect Permit F'ee&Issue Water Connection Permit <br /> 1. SUBTOTAL,of Perznit Requested: $ � ��O� <br /> 2. S1'ATE SURCHARGF, � �,pp <br /> 3, POSTAGE&FIANDLtNG(Only on Mail-Tn Applications) $__ �.Oti. �(� <br /> 4, TQTAL PERMIT FEE(Add Lines E-3 Above) $ ��� ,Q� <br /> AADI'TIONAI.INFURMAT'Tt7N-W,ATER 11iI�TERS <br /> ■ WATER METERS must be picked up and paid for at Orono City Halt,these are on a,�parate permit. <br /> ■ WATER METERS mnst be set and sealed by Orono Water Department (952) 249-4600, upon <br /> comptetion of ineter installation. <br /> The undersigned hereby applies to ttze Czry 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 atl statements made on this application are, true and correct. <br /> Applicant: ���� (����_ Date: ��,� <br />