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. <br /> DETERMINING PERNIIT FEES <br /> ❑SAC Charge(2�9 Rate=52,000.00) $ <br /> (SAC Chatge must accompany ail sewer permit applications unless prepaid) <br /> (Orono City Staff can determine if applicable) <br /> (If not prepafd,a sewer connection permit will not be issued) <br /> Sewer Connection!Disconnect/Repalr(SS0.00/Per Stub) a b �'�S � � <br /> Pipe siu inches;material Schd 40 air tested; cast iron <br /> ❑Water Connection/Disconnect/Repair(a50.00/Per Stab) a <br /> Pipe si�e inches;material Schd 40 air te.sted; copper <br /> 1. SUBTOTAL of Permit Requested: $ <br /> 2. STAT'E SURCHARGE $ .SO <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applicarions) $ 2,pp <br /> 4. TOTAL PERMYT FEE(Add Lines 1-3 Above) a ��� •' �� <br /> ADDITIONAL INFORMATION-WATER METERS <br /> ■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a s e�g�t. <br /> ■ WATER METERS must be set and sealed by Orono Water Deparlment(952)249-4600, upon <br /> completion of ineter installatton. <br /> The undersigned hereby applies to the City of Orono for issuance of a Utility Pernut,agrees to do <br /> all work in strict accordance with the ordinances of the City and the regulations of the State of <br /> Minnesota,and certifie all state ts made on this application are,true and correct. <br /> , <br /> �— ��--- <br /> Applicant: Date: ����/ � � <br /> R et�orm <br /> �', <br /> ✓ <br />