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► <br /> �- ► <br /> � <br /> ,::- {t ' , ',;�+� , DETERMININC��.ERIVIIT FEES; , `' � ,=- ,,', ,�°� <br /> �. � <br /> ❑ SAC Charge(2005 Rate=$1,550.00) $ <br /> (SAC Charge must accompany all sewer pernut applications unless prepaid) <br /> (Orono City Staff can determine if applicable) <br /> (If not prepaid,a sewer connection permit fvill not be issued) <br /> �Sewer Connectio Disconnec /Repair($35.00/Per Stub) $ <br /> Pipe size in s; ial Schd 40 au tested; cast iron <br /> �Water Connection/ isconnect Repair($35.00/Per Stub) $ <br /> Pipe size inc Schd 40 air tested; copper <br /> 1. SUBTOTAL of Pernut Requested: $ <br /> 2. STATE SURCHA.RGE $ .50 <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applicadons) $ 1.50 <br /> 4. TOTAL PERMIT FEE(Add Liues 1-3 Above) $ <br /> ADDITIONAL INFORMATION—WATER METERS' <br /> ■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a s�arate pernut. <br /> ■ WATER METERS must be set and sealed by Orono Water Department (952) 249-4600, upon <br /> completion of ineter installation. <br /> The undersigr►ed hereby applies to the City of Orono for issuance of a Utiliiy 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 teine ts made on this application are,true and conect. <br /> � <br /> � f�� <br /> Ap�licant: —�1 Date: � <br />