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. <br /> i <br /> � ' DETERMINII�TG PERMIT FEE� ` <br /> ❑ SAC Charge(2005 Rate=$1,450.00) $ <br /> (SAC Charge must accompany all sewer pernut applications unless prepaid) <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) $ <br /> Pipe size�inches; material '��" Schd 40 air tested; cast uon <br /> �ater Connection/Disconnect/Repair($35.00/Per Stub) $ <br /> Pipe size�inches;material , - cast iron <br /> ��j'��. <br /> 1. SUBTOTAL of Permit Requested: $ <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) $ <br /> ADDITIONAL INFORMATION—WATER METERS <br /> ■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a separate germit. <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 /> 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: � ` �% C� ! <br /> k <br /> � <br /> � <br /> � <br /> f <br /> � <br /> ; <br /> � <br /> I <br /> ; <br /> I <br /> � <br /> � <br />