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, . <br /> DETERMIN]lNG PERNIIT FEES <br /> ❑SAC Charge(2009 Rate=$2,000.00) � <br /> (SAC Charge must accompany all sewer permit applications unless prepaid) <br /> (Orono Ciry Staff can determine if applicable) <br /> (If not prepaid,a sewer connection permit will not be issued) <br /> �'S�ewer Connection/Disconnect/Repair($50.00/Per Stub) $ <br /> Pipe size inches;material Schd 40 air tested; cast iron <br /> �'Water Connection/Disconnect/Repair($50.00/Per Stub) $ <br /> Pipe size inches;material Schd 40 air tested; copper <br /> 1. SUBTOTAL of Permit Requested: $ <br /> 2. STAT'E SURCHARGE $ .50 <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ <br /> ADDITTONAL iNFORMATION-WATER METERS <br /> ■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a s�arate permit. <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 /> aii 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 conect. <br /> 30 —O <br /> Applicant: ��� Date: yr � <br /> Reset Form <br /> I <br />