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r <br /> DETERMINING PERMIT FEES <br /> � SAC Charge(2014 Rate=$2,485.00) $ <br /> (SAC Charge must accompany all sewer permit applications unless prepaid) <br /> (Orono Ciry Staff can determine if applicable) <br /> (If not prepaid, a sewer connection permit will not be issued) <br /> .�] Sewer Connection Charge—City of Wayzata(Pass Through Fee) $ <br /> (2013 Rate=$590.00) <br /> � Water Connection Charge—City of Wayzata(Pass Through Fee) $ <br /> (2013 Rate-$2,122.00) <br /> ❑ Water Connection Opt-Out—(Please Initial) <br /> I am choosing not to hook-un to water at this time. <br /> ❑ Water Availability— (Please Initial) <br /> I am choosing not to hook-up to water at this time. I have chosen to <br /> have my contractor make it water available for future hook-up. <br /> Water Availability 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 /> TOTAL PERMIT FEE(Add Fees Listed Above) $ � � <br /> � � � � <br /> ADDITIONAL 1NFORMATION—WATER METERS <br /> ■ WATER METERS must be picked up and paid for at Orono City Hall, these are on a separate permit. <br /> Typically the contractor will pick-up and pay for this permit. <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 accardance with the ordinances of the City and the regulations of the State of <br /> Minnesota, and certifies that all statements made on this application are,true and conect. <br /> � � � l � � I � �� <br /> Owner: Date: <br /> f <br />