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PETITION, WAIVER AND AGREEMENT FOR PAYMENT OF THE COST OF <br /> INSTALLATION AND CONNECTION OF, OR REPAIRS TO, PRIVATE UTILITY LINES <br /> AND ASSESSMENT OF AMOUNTS PAID AS A SPECIAL CHARGE UNDER <br /> MINNESOTA STATUTES, SECTION 429.101 <br /> TO: City Council of the City of Elk River <br /> Hu be C ;. ,� . 1� �'.� t. M �'� " (the Owners), owners of the property <br /> located at 11< N 14 V�.) and legally described on <br /> Exhibit A attached hereto (the Property), <br /> Petition the City of Elk River (the City) to pay the costs of installation and connection of, or <br /> Repairs to, (the Work) private utility lines located on the Property or in the Right-of-Way <br /> directly adjacent to the Property, including: <br /> X Installation and connection of private water service lines <br /> Installation and connection of private sanitary sewer service lines <br /> Repair of private water service lines <br /> Repair of private sanitary sewer service lines <br /> In an amount not to exceed that set forth on Exhibit B attached hereto (Cost of the Work); and, <br /> To levy a special assessment against the Property as an unpaid special charge pursuant to <br /> Minnesota Statutes, Section 429.101 in the amount of the Cost of Work plus the total of the <br /> following charges (if Applicable):. <br /> Cost of the Work (from Exhibit B) <br /> O 0 Sewer Access Charge (fill in current year fee) <br /> S 3 Water Access Charge (fill in current year fee) <br /> 000 Trunk/Lateral Charges (to be determined based on <br /> costs to provide services) <br /> TOTAL ASSESSMENT AMOUNT <br /> (Sum of all listed amounts) <br />