Laserfiche WebLink
Jul 01 2013 0929AM Matts Plumbing Solutions 7637842204 page 3 <br /> �i , <br /> �'!t'd, b..'Fti^:Lvr�t .{;��' ` +,� I'u ii�� • : . � �f . •-,,aF �• ; ������g n,i <br /> .. „ w .W c ,1��� �, . , �' �•• ' <br /> . :: �. . ._.. ,�. .. , , <br /> a� z'sa <br /> ❑SAC Charge(2013 Rate=$2,435.00) S <br /> (SAC Charge must accompany atl sewer permit applications unless prepaid) <br /> (Orono City Staff can determine if applicable) <br /> (If not prepaid,a sewer connectlon permit w3ll not be issued) <br /> �Sewer Connection!Dtsconnect/Repair(�50.00lPer Stnb) $ ��7�� n � <br /> Pipe size_�inches;material 4�I�Schd 40 air tested;_P�' cast iron <br /> ❑Water Connec�ion/Disconaect/Regair(S5a.D0/Per Stub) $ <br /> Pipe size inches;material Schd 40 sir tested; coppe,r <br /> ❑Water Availab�ity For l�tare Hook-Up M Water(S50.00) $ <br /> Water Availabilitv Exnlanatlon: <br /> Contractor installed line to inside of kwuse for future 600k-up. <br /> This line will be inspected by the Public Works Departrnent. <br /> Reauired Before Water Connectian Pertnit is I�sued: <br /> l. Issue Water Meter 8t Hom Permit <br /> 2. Any Additional Connecdon Fces Paid(If Applicable) <br /> Isaue Water Connection Pernut: <br /> 1. Collect Permit Fee&Issue Water Co�mection Permit <br /> 1. SUBTOTAL of Pennit Requested: $ '��-� <br /> 2. STATE SURCAARGE $ S,ap <br /> 3. POSTAGE&HANpLING(Only on Mail-[n Applications) $ 2.pQ <br /> 4. TOTAL PERII�IIT FEE(Add Lines 1-3 Above) $ t�1'� ,� Y <br /> ADDITI�NAL INFORMATION—WATER METERS <br /> ■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a seperate ocrmit. <br /> ■ WATER METERS mast be �et and sealed by Orono Water Departmeat (452) 249-4600, upon <br /> completion of ineter instnllatlon. <br /> The undersigned hereby applies to the City of Orono for issuance of a Utility Permit,agrees to do <br /> all work ia strict accordance with the ordinances of the City and the regulations of the State of <br /> Minnesota,and certifees that all statements made on this application are, hue and correct. <br /> ' r <br /> Applicant: Date: � � � � <br />