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� <br /> . <br /> �c��c�t�s�ot�.�� r� <br /> �p�, City of Orono l��Rec��ed �� i�epnrt� <br /> � ._ . <br /> O O P.O.Box 66 ` <br /> 2750 Kelley Parkway O 1n-T�Tp�e��1�pete�m�naqqn�t�rm�qt�lplefet� E,, <br /> �'' Crystal Bay,MN 55323 <br /> � ��� " � � (952)249-4600 AppCtt�Bd�3��I�'R�jp�d� <br /> `�sr� � � � � ��� <br /> CITY OF ORONO—HOMEOWNER SUPPLEMENTAL FORM <br /> WAYZATA-SEWER& WATER PASS THROUGH CONNECTION FEES& SAC FEES <br /> (ALL PERMII'S-Mav be subiect to further review and mav not be issued when t6e aonlication is receivedl <br /> PERMIT CODES(IN-HOUSE) <br /> Sewer/Residential/Pass Through Fees/Blank <br /> Wated Residential/Pass Through Fees/Blank <br /> Sewer&Water/Residential/Pass Through Fees/Blank <br /> G'rE1�tERi�:G Th7FC�II�MMATit'�N <br /> 1. SAC&SEWER&WATER CONNECTION FEES CAN'T BE PREPAID—UNLESS THE <br /> CONTRACTOR WILL BE PULLING THE PERMIT IN A FEW DAYS. <br /> (PER MET COUNCIL). <br /> 2. If payments are made: Prior to the actual sewer or water connection permit(pulled by the <br /> contractor)the payment will be held until that permit is received and paid for. <br /> 3. These payments can only be made with check or cash,because they are pass through fees. <br /> 4. If you the homeowner wants proof of this payment,we will hand write a payment receipt. <br /> 5. We will not hold this payment more than a few days to one week,at which time if the contractor <br /> does not come in we could reserve the right to return your check to you,or collect additional fees <br /> that could change. <br /> 6. Once the sewer or water connection permit is issued,we will issue this permit and send you the <br /> homeowner a copy. <br /> �.:� � ��� <br /> _ <br /> : T�'PEFQF FERIvIIT ` ; <br /> : Ghec�;All Tha�.A 1 <br /> ❑Residential(May Require Approval) <br /> ❑ New Connection [�Water Availability Connection For Future Hook-Up to Water <br /> Job Site/.Qwr�er Inf�rma.t�.c�n. : ; <br /> �. `. <br /> Site Address: ,�Q �'�C vCA,Jnp� � <br /> Owner:1�,��C t��cp ,�"/��T,�,v�j1� Mailing Address: � � �, <br /> City: WD Zip: �53� � <br /> Home Phone: �52-- T��—���'� Alternate Phone: �'SZ-3$�0- g 3 7 � <br />