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�, '.', DE' ER I I GPERMITFEES,= � _, ;. <br /> [ SAC Charge(2007 Rate=$1,675.00) $ ll/(7S 6& <br /> (SAC Charge must accompany all sewer permit applications unless prep2fid) <br /> (Orono City Staff can determine if applicable) <br /> (If not prepaid,a sewer connection permit will not be issued) <br /> [Sewer Connection/Disconnect/Repair($35.00/Per Stub) $ 3 Si. 0 D <br /> Pipe size 9 inches;material P✓(�Schd 40 air tested; n cast iron <br /> D Water Connection/Disconnect/Repair($35.00/Per Stub) $ <br /> Pipe size inches;material Schd 40 air tested; 0 copper <br /> 1. SUBTOTAL of Permit Requested: $ 1,3'(D. o Q <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) $ 17//. 5-® <br /> ADDITIONAL INFORMATION—WA 1'LR 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:AbISII,..0 , p-Cti <br /> Reset Form <br /> C-A4.� k Wets .�-i !4 _s lel .....I_ •. <br /> / ..AC- G.a.f. Qom,_._..__ ..rLff, sf►v.• . <br /> #�,k<..a"m/r.4 <br />