Laserfiche WebLink
, May �1 13 08:52a Westonka Mechanical 952-472-4961 p.3 <br /> ' 85i3�'2013- 08:47 4522494616 uKunu ' "''" "" "` <br /> ❑SAC Cha�ge(2013 Rate=SZ,435.00) � <br /> (SAC Charge must accompany all sewer per+nit applicaticros unte�s Fmpaid) <br /> (OronuCity Staff can determine if applicable) <br /> (T{Apt p�ep�;d,a sswer conne¢tion permi!witl not be sssued) <br /> ❑Sewer Grynnr 9or 1 Disconnect/Repair(Ti50.0AlPer Stvb) S <br /> Pi��e size�mcJ�es;m.aizrial�Sehd 40 air tested: cast ivoa <br /> ❑ Water Coanection i viscoanecl/Repafr(�3I1.110lPe�Stnb) S <br /> �'Ipe sixe .''► inchas;matcrial ''� Schd�O�air ecs�cd; aopFct <br /> 4�P <br /> ❑Water Availability For t�nture HooNrUp M Waber(S5A.(1A) $ <br /> Water Availabilitv E Ia�„naticn]: <br /> Contra�tor instbilcd linc to icsidc oPhous�for fuairc hook-�cp. <br /> Tl�ic line will be ins(.�D�d bY tt+e Pub��Watks Departrnent• <br /> R���,;red Before water Cmutiectioa Permit is issuod: <br /> 1. TFsoe Water 11Netec 8c�lom Perrnit <br /> 2. Any Additionat CoanectEonFees Paid(tf Applicabk) <br /> Is9uc Watet Connection Pennic: <br /> 1. CoEloa Pcren'st Fcc&[s9uc Water Cormection�ermit <br /> 1. SUB'I'O'x'Ax.of Permit Req�usted: $ <br /> 2. STA'S`E SURCHARGE $ 5.00 <br /> 3. P�Sl'AGF&HfiNDL1NG(Qn(y on Msil•in Appiications) S Z.00 <br /> 4. TOTAL PERMIT FEE(l�dd Lines 1-3 Abova) � <br /> �' <br /> -- • - _�1,E#�• - 'Ir�FORM�TTE�h'c�—"'.'9�'s�� �7_iE��Rc�::`"w:"- ;�::- <br /> • W ATER MLTERS must be picked up sn�Yraid for at Orono City Ha11,thes�arE an a se�arste oermit. <br /> • WA?ER MET£RS mnst be set and scAkd by Orono wat,er Dep�rtmcnt(952)249-460@, aPon <br /> Minpletion ot meter iastallation. <br /> The undersigned hercby aj�plies to the City of Orono for issuancc vf a LJtility Pcrtnit,agrces to do <br /> all work in striet aceocdance with the ardir�atnces af the City and the regulations of the Stat�o.f <br /> Minnesota,and certEfies t�iat�II stotem ts mt�de�on t��is applicatian are,true and carcect. <br /> � <br /> � �`� �- �� <br /> A.pplicant: Datt: <br />