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, <br /> � . <br /> I�]E�:F�IVI��TC�1�ER�I?'FE� <br /> ❑SAC Charge(2015 Rate=52,485.00) $ <br /> (SAC Charge must accompany all sewer permit applications unless prepaid) <br /> (Orono City Staff can determine if applicable) <br /> (If not prepaid,a sewer connection permit will not be issued) <br /> wer Connection/Disconn air .00/Per Stuti) $ <br /> ipe size inches;material cl�ir tested; cast iron <br /> ❑Water Connection/Disconnect/Repair($50.00/Per Stab) $ <br /> Pipe size inches;material Schd 40 sir tested; copper <br /> ❑Water Availability For Future Hook Up to Water($50.00) � <br /> Water Availabilitv Eznlanatlon: <br /> Contractor installed line to inside of house for future hook-up. <br /> This line will be inspected by the Public Works Department. . <br /> Required Before Water Connection Permit is Issued: <br /> 1. Issue Water Meter&Hom Pernut <br /> 2. Any Additional Connection Fees Paid(If Applicable) <br /> Issue Water Connection Permit: <br /> 1. Collect Permit Fee&Issue Water Connection Permit <br /> 1. SUBTOTAL of Permit Requested: � <br /> 2. STATE SURCHARGE S 1.00 <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applicarions) S 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ <br /> ADDITIONAL INFORMATI03�T-V�ATER METERS <br /> ■ WATER METERS must be picked up and paid for at Orono City Hall,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 /> �innesota, and certifies at all statement e on this application are,true and rrect. <br /> , l� 9 /� <br /> .nt: Date: <br />