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r r.. ' r 't I3E 1'ERMINING PERMIT F EES,,' y`, <br /> ❑ SAC Charge(2005 Rate=$1,450.00) $ <br /> (SAC Charge must accompany all sewer permit applications unless prepaid) <br /> (Orono City Staff can determine if applicable) <br /> (If not prepaid,a sewer connection permit will not be issued) <br /> E Sewer Connection/Disconnect/Repair($35.00/Per Stub) $ k oC) <br /> Pipe size t/''.Chinches;material Schd 40 air tested; cast iron <br /> Lf0 <br /> 1RIVater Connection/Disconnect/Repair($35.00/Per Stub) $ Se;6 c? <br /> Pipe size I inches;material Schd 40 air tested; cast iron <br /> 1. SUBTOTAL of Permit Requested: $ . d c) <br /> 2. STATE SURCHARGE $ ,50 <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ 7o, _s—c) <br /> ADDITIONAL INFORMATION WATER METERS <br /> • WATER METERS must be picked up and paid for at Orono City Hall,these are on a separate permit. <br /> • WATER METERS must be set and sealed by Orono Water Department (952) 249-4600, upon <br /> completion of meter 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 /> Applicant: � � Date: `) g —d, <br />