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. . � �`��`' N�.`�����`E�`� ' ' DETERMINING PERMIT FEES �:� �,, � <br /> ❑ SAC Charge(2009 Rate=$2,000.00) $ <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/Repair($50.00/Per Stub) $ 5 Q ,��,, <br /> Pipe size `�%�inches;material�},�,,, Schd 40 air tested; cast iron <br /> �c <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) $ C��_F� <br /> Water Availabilitv Explanation: <br /> Contractor installed line to inside of house for future hook-up. <br /> This line will be inspected by the Public Works Department. <br /> Required Before Water Connection Permit is Issued: <br /> 1. Issue Water Meter&Horn Permit <br /> 2. Any Additional Connection Fees Paid(If Applicable) <br /> Issue Water Connection Permit: <br /> 1. Collect Permit Fee&Issue Water Connection Permit <br /> l. SUBTOTAL of Permit Requested: $ � �F r,,,�� <br /> -� <br /> 2. STATE SURCHARGE $ .50 <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ 1�b, Sp <br /> ADDITIONAL INFORMATION—WATER METERS <br /> ■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a separate peimit. <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 far issuance of a Utility Permit, agrees to do <br /> all wark in strict accordance with the ardinances 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 /> Applicant: �� �� Date: f C�� �7�vy <br />