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� <br /> °�' � '":�ETERIvIIi�1ING PERMIT FEES I <br /> � <br /> ❑ SAC Charge(2009 Rate=$2,000.00) $ <br /> (SAC Charge must accompany all sewer permit applications unless prepaid) <br /> (Orono City Staff can determine if applicab]e) <br /> (If not prepaid,a sewer connection permit will not be issued) <br /> G� <br /> ewer Connection/Disconnect/Re air($50.00/Per Stub) $ `�Q <br /> Pipe size�inches;materia]�Schd 40 air tested; cast iron <br /> ❑Water Con�ection/Disconnect/Repair($50.00/Per Stub) $ <br /> Pipe size inches;material Schd 40 air tested; copper <br /> 1. SUBTOTAL of Permit Requested: $ <br /> 2. STATE SURCHARGE $ .50 <br /> 3. POSTAGE&HANDLING (Oniy on Mail-In Applications) $ 2.00 <br /> 4. TOTAL PERMTT FEE Add Lines 1-3 Above �' <br /> ( ) � ��n's <br /> ADDITIONAL 1NFORMATION-WATER METERS <br /> ■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a separate permit. <br /> ■ WATER METERS must be set and sealed by Orono R%ater 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 accorda e with the ordinances of the City and the regulations of the State of <br /> Minnesota,and certifies� all sta ements made on this application are,true and correct. <br /> r � <br /> Applicant: Date: / � /� I <br /> Reset Form <br /> � <br /> .�'..p .. ,� <br /> I <br /> � <br /> I '' <br /> . , i ' <br /> 1 I <br /> � I,r <br />