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� !� e <br /> ❑SAC Charge(2009 Rate=$2,000.00) $ <br /> (SAC Charge must accompany all sewer permit applicarions unless prepaid) <br /> (Orono City Staff can determine if applicable) <br /> (If not prepaid,a sewer connection permit wi►I not be issued) <br /> �Sewer Conn t�on/Disconnect/Re air($50.00/Per Stub) $ <br /> Pipe size�inches;material�Schd 40 air tested; cast iron <br /> �Water Connection/Disconnect/Repair($50.00/Per Stub) $ <br /> Pipe size_�inches;material Schd 40 air tested; copper <br /> 1ci��.l� �V�.c.-� <br /> 1. SUBTOTAL of Permit Requested: $ <br /> 2. STATE SURCHARGE $ .50 <br /> 3. POSTAGE&HANDLING(Only on Mai]-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ <br /> �I�T�'���I�?�C� :�.��T-�V��'�T���1�'3�� <br /> ■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a sevarate 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 /> Minnesota,and certifies that all statements made on this application are,true and correct. <br /> �. <br /> Applicant: � Date: � �� <br /> �I �! ,`6 <br />