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v� <br /> �� <br /> i <br /> �ox crr�:us�o�v��r <br /> ,¢�� City of Orono I�ateRar.eiv�i: Pemut# � �� <br /> 0. Q P.O.Box 66 ;��, �, ;: <br /> 2750 Kelley Parkway �Tri C�?o�se SAC Det�nxtu�a6Qn�'ortn Cc�mpl�ted, <br /> �' Crystal Bay,MN 55323 � �" � � � <br /> � ,�a�.�a� (952)249-4600 Approved�3y(If Aequired): <br /> CITY OF ORONO—HOMEOWNER SUPPLEMENTAL FORM <br /> WAYZATA- SEWER&WATER PASS THROUGH CONNECTION FEES& SAC FEES <br /> (ALL PERMTTS-Mav be subiect to further review and mav not be issued when the aaalication 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 /> �ENERAL I'i'�TF��tMATI�I�T <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 /> TI�'PE OF FERI�IT <br /> (Gheek A11 That�A 1 } <br /> �r <br /> Residential(May Require Approval) <br /> ❑ New Connection ❑ Water Availability Connection For Future Hook-Up to Water <br /> Job Site/��mer Irifor.�iat�on: i <br /> Site Address: � �, �KK�S+-I�XSoc�. ��-d- SS 3� ( <br /> Owner���2�n Su�G..n Sc+rl Mailing Address: � <br /> c�ty: C�Rono � v�Sa�.eza�-o� zip: 5 S3°�) <br /> Home Phone: °t52-23�1- �Z2s Alternate Phone: q52-23a-��D� <br />