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i .i. <br /> �� ^+ � =� �� ` �'t " �7 �r�� d�� '"b�dg a•a. :. <br /> ���� ��`�� ���.:���� .���.,���.ti��,�TERN1IN12�G�PERIVIIT�EES :���k �'�� �;���,�'��� ���� ������ <br /> ❑ SAC Cha ge(2005 Rate=$1,450.00) $ <br /> (SAC Ch rge must accompany all sewer pernut applications unless prepaid) <br /> (Orono ity Staff can deternune if applicable) <br /> (If not p epaid,a sewer connection permit will not be issued) <br /> � Sewer Co nection/Bf�rtect/ ) $ <br /> Pipe size inches;material Schd 40 air tested; cast iron <br /> ❑Water ection/Disco Repai 35.0 /Per Stub) $ <br /> Pipe e inches• te 'al Sc 0 air tested; copper <br /> Z�� - o�-� �- � �� �`t'�.�,� <br /> 1. SUBTOT of Pernut Requested: $ <br /> 2. STATE S CHARGE $ .50 <br /> 3. POSTAG &HANDLING(Only on Mail-In Applications) $ 1.50 <br /> 4. TOTAL ERMIT FEE(Add Lines 1-3 Above) $ <br /> ' DITIONAL INFORMATION-,WATER METERS <br /> ■ WATER METE S must be picked up and paid for at Orono City Hall,these are on a separate uernut. <br /> ■ WATER METE S must be set and seated by Orono Water Department (952) 249-4600, upon <br /> completion of m ter installation. <br /> The undersigned he eby applies to the City of Orono for issuance of a Utility Permit, agrees to do <br /> all work in strict ac ordance with the ordinances of the City and the regulations of the State of <br /> Minnesota, and cert'fies that all statements made on this application are,true and correct. <br /> Applica : ' � Date: __ �'' 9—O� <br /> a <br /> ; <br /> � <br /> �� <br /> � <br /> � P� <br /> � �� ';i � a' 9 � <br /> , <br /> � <br /> � i � ; �' � � �I � <br /> r N � <br /> IY, 1 ; �' r ' � � � �� <br /> • . .. . �: .. . .. . � . rt . � . w.! �u �� I �"li �' �i .� �' . <br />