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L <br /> . � <br /> ` ` DETERMINING PERMIT FEES ` <br /> ❑ SAC Charge(2005 Rate=$1,450.00) $ � � y��G� <br /> (SAC Charge must accompany all sewer permit applications unless prepaid) <br /> (Orono City Staff can deternune if applicable) <br /> (If not prepaid,a sewer connection permit will not be issued) <br /> � mc <br /> ❑ Sewer Connection/Disconnect/Repair($35.00/Per Stub) $ ,�� ��' <br /> Pipe size�inches;material�(�� Schd 40 air tested; cast uon <br /> ❑Water Connection/Disconnect/Repair($35.00/Per Stub) $ <br /> Pipe size inches;material Schd 40 air tested; copper <br /> 1. SUBTOTAL of Pernzit Requested: $ <br /> 2. STATE SURCHARGE $ .50 <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50 <br /> � <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ �� t��,-�"" <br /> ADDITIONAL INFORMATION-WATEK 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 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: ����e'���" Date: '-'f' � <br /> - —,, <br /> I <br /> ; ' <br /> � � � <br /> � ; <br /> , [ � <br /> 1 1 p <br /> � �� r � <br /> 9 1�. � <br /> � i i�; � I�.� 1 <br />. � . � i � �� � � 4 <br /> } � � <br /> - � ' �. I � ��f � � <br /> 'i � 1 1 <br /> i I�, � ' I M� � �: � � �^ <br /> .� � G': : ,� �iit iq � G� I H 4 I � <br /> � ' i - . q � �-i � r � r., ���1� � ��. � � �� <br />. . . ., . � .. , - � . , � .. . . ;ti �. ,e! t I;• -tl . , <br />