Laserfiche WebLink
08/21/13 12:17 OLSONCONSTRUCTION 9524485289 p.06 <br /> ❑SAC Charge(2013 Rate=52,435.00) $ <br /> (SAC Charge must accompany all sewer permit applications unless prepaid) <br /> (Orono City Staff can determine if applicable) <br /> (If not prepaui,a sewer conneetion permit will not be issue�l) <br /> ' �Sewer Connection 1 Discoanect/R�pair(550.00/Per Stub) S ��` ��j <br /> Ptpe size " inches;material � Schd 40 air tested; cast iron <br /> �Water Conngction/Disca�nect/Repair(550.00lPer Stub) ,% $��� l.�� �./�.J <br /> Pipe size_�inches;materia] Schd 40 air tested; ''� copper � <br /> ❑Water Availabelity For Future H.00k-Up to Water{550.00) $ <br /> Water Availabilitv Exnlaaation: <br /> Conuactor insta.11ed line to inside of house for future hook-up. <br /> 'This line witt be inspected by the Public Works Department <br /> R�e uired Before Water Connection Permit is ls u : <br /> 1. Issue Water Metet 8t Horn Permit <br /> 2. Any Additional Connection Fees Paid(If Applicable) <br /> iac�►e Water Connection Permit: <br /> 1. Collect Permit Fee&Issue Water Connection Permit <br /> 1. SUBTOTAL of Permit Requested: $ �`'�` �•�----' <br /> 2. STATE SURCHARGE S 5•00 <br /> 3. POSTAGE&F�ANDLING(Onty on Mail-In Applications) $ __2.00 <br /> 4. TOTAL PERNIIT FEE(Add Lines 1-3 Above) $ ,f(.,✓ 7. G.,7�� <br /> �DT'�IC)�T.f�I�OR1v�A'TIUN�W�.T�R METER.�' <br /> • WATER ME'CERS must be picked up and paid for at Orono City Hall,these are on a senarate nermit. <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 regulatians of the State of <br /> Minnesota,and certifies that all statements made on this applica� n are,true c!co eet. <br /> r <br /> Applicant:. M � --� ate: � � � <br />