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� <br /> '`� IDETERMINING'PERMIT FEES; ° , .<. <br /> ❑ SAC Charge(2005 Rate=$1,550.00) $ <br /> (SAC Charge must accompany ail sewer pernvt applications unless prepaid) <br /> (Orono City Staff can deternvne if applicable) <br /> (If not prepaid,a server connection permit will not be issued) <br /> �Sewer Conne tion/Disconnect/Repair($35.00/Per Stub) $ <br /> Pipe size�inches;material�U _C,Schd 40 air tested; cast iron <br /> [�Water Connection/Disconnect/Repair(�35.00/Per Stub) $ <br /> Pipe size_�inches; inaterial C��_Schd 40 air tested; copper <br /> .� <br /> �/� <br /> 1. SUBTOTAL of Pernut Requested: $ <br /> 2. STATE SURCHARGE $ .50 <br /> 3. POSTAGE&HANDLING(Only on Mail-I��Applications) $ 1.50 <br /> 4. TOTAL PERMIT FEE(Add L'uies 1-3 Above) $ <br /> ADDITIONAL INFORMATION-WATER 1VIETERS <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 Wate►- Department (952) 249-4600, upon <br /> completion of inetei•installation. <br /> The undersigned hereby applies to the City of Orono for issuance of a Utility Peiznit, agrees to do <br /> all work in sn-ict 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 coiYect. <br /> Applicant: ' Date: <br />