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❑SAC Charge(2014 Rate=$2,485.00) $ <br /> (SAC Charge must accompany all sewer permit applications unless prepaid) <br /> (Orono City Staffcan 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� <br /> Pipe size inches;material Schd 40 air tested; cast iron <br /> �Water Connection/Disconnect/Repair($50.00/Per Stub) $_�V <br /> Pipe size inches;material Schd 40 air tested; copper <br /> ❑Water Availability For Future Aook-Up to Water($50.00) $ <br /> Water Availabilitv Exalanation: <br /> Contractor installed line to inside of house for futwe 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 /> 1. SUBTOTAL of Permit Requested: $ ��� <br /> 2. STATE SURCHARGE $ 5.00 <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ � ��� <br /> � � _, ":_,' A;�?�7�`TT{�1��I:��N'FO��VIt��tJ�"=�'`�V�`�,1'�I,��'�"�JRS . : '; 4�4: <br /> ■ WATER METERS must be picked up and paid for at Orono City Hail,these are on a separate permit. <br /> ■ WATER METERS must be set and sealed by Orono Water Department (952) 249-4600, upon <br /> completion of ineter installation. <br /> The undersi ed reby applies to the City of Orono for issuance of a Utility Permit,agrees to do <br /> all work in rict cco dance with the ordin ces of the City and the regulations of the State of <br /> Minnesota, d c ifi all s ements de on this application aze,true and correct. <br /> R ���� <br /> Applicant: Date: <br />