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._ _. � ._ _ <br /> r <br /> a <br /> J <br /> DETERMINING PERMIT FEES <br /> ❑ SAC Charge(2005 Rate=$1,450.00) $ <br /> (SAC Charge must accompany all sewer pernut applications unless prepaid) <br /> (Orono City Staff can deternune if applicable) <br /> (If not prepaid,a sewer connection permit will not be issued) <br /> � Sewe�.,�onnection'/Disconnect/Repair($35.00/Per Stub) $ <br /> � Pipe size ` --�ches;material Schd 40 air tested; cast iron <br /> ❑Water Connection/Disconnect/Repair($35.00/Per Stub) $ <br /> Pipe size inches;material Schd 40 air tested; copper <br /> 1. SUBTOTAL of Pennit Requested: $ <br /> 2. STATE SURCHARGE $ .50 <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applicatious) $ 1.50 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ <br /> ADDITIONAL 1NFORMATION—WATER METERS <br /> ■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a separate pernut. <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 accardance with the ordinances of the City and the regulations of the State of <br /> Minnesota, and certifies that all statements made on this application are, true and correct. <br /> ,�. <br /> Applicant: Date: ��ll, �� a'�l Q � <br />