Laserfiche WebLink
Mike 9524679058 p.3 <br /> � Oct-06-2011 08:2ta� Ftom-CITY 4P ORONO +9522461616 T-212 P.002/OOZ f-601 <br /> � <br /> ❑SAC C�arge(2011 Rate i SZ�Z30.OE1) � <br /> (SAC Cherge must accoflopaay all sawer persait applicatioas unless prepuid) <br /> (�ono Ciry Stsff cc�u decerr�oue if appIice6le) <br /> (Itrot propnid,s►sewer oonca�tio 't aaill bot be issued) <br /> �SBweT COR7iCCIlOA/Di�CO4aeM air Sd.00/Per Stub) S_ <br /> Pipe si�e iac�s;�aacesial d 40 air�es�ed� CiSt 7t�:M <br /> ❑Water Coaaection J D�woonnec�I Rrpair(S50.Oa/Per Stub) S_.. <br /> Pipe aiu iaches;maurial Schd 40 air tesred; copper <br /> ❑W:ter�►vailability�or Future Hook-Up to'OVacer(F50.00) S_ <br /> WateT Availabiiitv Ezplan�tion: <br /> Coutractor insmUed lmc m iAside ofbou9e foz fupue hook up. <br /> T6i91ine�rill be inspecxd by tht Public Works Depuanent <br /> �q}�'ry�BeFore Water Conaecaoo Permit is Cssue,�� <br /> I. [seue Wazrr Mcar�Rorn Perm3t <br /> 2. Any Ad�di�onal Con�ueetion Faes Paid(Yf Applicable) <br /> ���,W,�u�G►nnection Perm'�r. <br /> 1. Collxt Permit Fx&lssoe Water Cotmecti�on P�it <br /> 1. StJSTOTAL of Permit Requeste�: �� <br /> . <br /> 2. STA'I�SURCFIARGE S_,,,, 5.00 <br /> 3. POSTAGE�H,4]VDLW�(Oaly��Ma�7-In Applicsriw�s) S� 200 <br /> 4. TOTAY.p�RMIT FEE(Add Liaes 1-3 Above) 5_ <br /> :tyi'i: � '�`�+' Ty , 'a�: . �... � �+�. <br /> i��� I' 'r..�.�.t(�Je..�N� r Yi .��• •��• ��.:iyt�'�J�i;���'�'':�f�Nt�.. <br /> � 'WATER 11�TERS musc be picked vp aod paid for�t Orono CitY Ha21,thase are 7o a a�arate n�a,it. <br /> � WATfi� MSTERS o�pst b� set �nd eealed by Oro�o Water Depxrtmeru (95Z) Z49-4606� npoa <br /> eompletion of�oeCet'ia9tall$tio4. <br /> The wzdersigned hereby applics to the Ciry of Orono for issuance af a'U'tility Prrmit,agrecs t4 da <br /> sIl v�ork in striet aceordaace with the ord�ances of 1he Ciry and ihe reguia�icros of the State of � <br /> Minnesow,and cercxfies tl�at sU st�tcmcats made on this applic�tion s�re,�ve ar,d cotrect. . <br /> � <br /> Ap�licaaC ��;�� "l r <br />