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. <br /> .�,.�. � •p���(' I , ' �,�)i ��'1 y� !� �i p� �tJ��(�I �i y ' rlq����I�, !I� �I <br /> �"�:`}� !�.@ "•h I �e I ��l��!1,��5 nl�,t i i?1k1��'� �� IM4�''r,?S1� 1.. ��`;�.'';'� #=r� .1']�i l��w41UNi�li k1 NI I;�i�a��?'i"C;�'�5�u�v�l �W'lll:'i' � <br /> �]SAC Charge(20UB Rate=�1e450.00) $ <br /> (SAC Ch3r�d Btust accOtppu�ly all scwer petiYti�ripplica�i0�g ut�lass prepaid) <br /> (Orono G�ry S1�f�aan d�tcrmine if appl�cable) <br /> (Yf not prepaid,u sewer conneccion permit rvi11 not be issucd), <br /> � /�Sower Connrctioa/l��lseaat�ect/ltopuir(�35.00/Per Stub) $ <br /> (_ � Pip�siza incTz�s; material Schd 40 air testad; cast uon <br /> [�W�1ter ContlrCtion/n56Cobpnct/Repair(S3SA0/Pet Stu�) � <br /> pipe 9i�e �nohes;rnaee.rial,�Schd 40 8iP tiested; C�BL i�on ' <br /> 1, S'CJBTOTA�of Perxuit lZequested: � <br /> 2. STAT$SURCHARG� $ ,�q <br /> 3. POSTAG�&fiANpLING(Only on 1via���Applicatians) � �� <br /> 4. TOTAL p�MIT'F�E(Add Liaes �-3 Above) � <br /> `� '� '' � �;� ���''A�D1TxUN�AL'INFORl�1A,TZ'4N—WAT�R�� � � ' ,;,, <br /> �;,,.,,.: <br /> ' 'nVATTR METERS must be picked up pt�d paid fnr at Orono Ciry HaXl,thcst are on a se�+�ra��Cm,i.t <br /> • 'GV.�TER METERS must be s�r ard sealed by Orono Watar Department (93Z) 249-4600, upu� <br /> �ompletiop of ineter�lnstaY�ucian. <br /> The urldc�signer�hereby�spplies to'Che Ciry of Orano for iss�ance or a TJt��ity Pera�i.x,agrees w do <br /> all work in su�ic� accordance with rhe ozdiass►ces o��rhe Ciry and thr re�lations of the at�tc of <br /> Minnesora,and cc�tifies that all sratc�uents made c�this application�e,true and eon�et, <br /> ApplicLnr. � DttCe: V ' ��d� <br /> Z0/ZB 39t�d 1SN0�13SNf1S 090Z6Lb�9L LO�ZZ 9e0Z/80150 <br />