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. <br /> DETERMINING PERMIT FEES <br /> ❑SAC Charge(2016 Rate=$2,485.00) $ �e d�i , (� <br /> (SAC Charge must accompany all sewer permit applications unless prepaid) ��� ��, <br /> (Orono City Staff can determine if applicable) � <br /> (If not pre aid,a sewer connection permit will not be issued) � � �/` <br /> � <br /> ewer Conne ' isconnect/Repair($50.00/Per Stub) $ �Cn ' <br /> Pipe size�inches;material�Schd 40 air tested; cast iron <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) $ <br /> 1 �C . �- <br /> Water Availabilitv Ezplanation: <br /> Contractor installed line to inside of house for future hook-up. <br /> This line will be inspected by the Public Works Department. <br /> Reauired Before Water Connection Permit is Issued: <br /> L [ssue 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 /> � <br /> 1. SUBTOTAL of Permit Requested: $ J� ` ' <br /> 2. STATE SURCHARGE $ .00 \ <br /> 3. POSTAGE&HANDLING(Only on Mail-[n Applications) $ 2.00 1 � I <br /> � �1\ ' <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ � . '� �" <br /> ADDITIONAL INFORMATION—WATER METERS <br /> -.'."._:�:�iLTERS must be picked up and paid for at Orono City Hali,these are on a senarate 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 accordance with the ordinances of the City and the regulations of the State of <br /> Minnesota, and certifi that al st tements made on this application are,true and conect. <br /> Applicant: Date: ��� � �" ����� <br />