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SAC DETERMINATION - 2010 <br /> (In-House Use Only—Updated 10/20/10) <br /> Date Completed: ���3 Date Determination Expires: 12/31/ <br /> Address: 1 s�(�� P� <br /> PI D: Q�I �7 - 2 3 -3 3 --oo Z-`� <br /> . . . . . <br /> r .. . . <br /> III ,', , IIII�III . . • . � II III II, , <br /> ..• . . .• . �� � <br /> . •• . .. . � �: . : <br /> .. . <br /> . . . . . <br /> �I . � , . <br /> . •• . � . .� .. . .. • .� . • � � <br /> • � r <br /> ^ ' ��• ' •' � � •� •.� <br /> �� � ' • • � •. � •� : • •• • � � s•� • <br /> v <br /> � . .. .. •� . . <br /> . � <br /> SAC Due: ❑ Yes [�.No <br /> If Demo Permit Being Issued—Get Copy of Utility Bill to Attach to Demo Permit:�Attached <br /> Comments to Key on Permit: , Z <br /> Notes: �kd M i�ra�it w�- �,,�, re�d - f rn� b� 3I3t��Z de� -� be. � zo� <br /> Completed By: � Date Completed: !�(3 <br /> Noie: <br /> • This form is for residential properties onlv that are already in a sewer area <br /> • Any commercial, industrial, religious or schools—determinations are made by Met Council in a/etter <br /> format(Lyle is contact personJ <br /> • Not for properties currently on septic, wantinp to hook-up to sewer for first time. These properties may <br /> not qualify, or may have to pay large sewer assessments in addition to SAC <br /> (Scott is the contact personJ <br />