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� DETERMINING PERMIT FEES <br /> ❑SAC Charge(2009 Rate=$2,000.00) $ <br /> (SAC Chazge must accompany all sewer permit 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($50.00/Per Stub) $ �7 0•S J <br /> Pipe size inches;material Schd 40 air tested; cast iron <br /> ❑Water Connecfion/Disconnect/Repair($50.00/Per Stub) $ <br /> Pipe size inches;material Schd 40 air tested; copper <br /> l. SUBTOTAL of Permit Requested: $ <br /> 2. STATE SURCHARGE $ .50 <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ ��� - �v <br /> ADDITIONAL INFORMATION-WATER METERS <br /> ■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a separatepermit. <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 /> . <br /> � �� � �Y� <br /> Applicant:_� Date: <br /> �', <br /> Rq/Se�t orm <br /> ✓ <br />