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� � <br /> � „ , � . : <br /> .� <br /> ❑ SAC Charge(2007 Rate=$1,825.00) $ <br /> (SAC Charge must accompany all sewer pernut applications unless prepaid) <br /> (Orono City Staff can deternune if applicable) <br /> (If not prepaid,a sewer connection permit will not be issued) <br /> ❑ Sewer Connection/Disconnect/Repair 5.00/Per Stub) $ <br /> Pipe size�inches;material \ �7chd 4 air tested; cast iron <br /> --�-- <br /> ❑ Water Connection/Disconnect/Repair ($35.00/Per Stub) $ � � �� <br /> Pipe size inches; material Schd 40 air tested; copper <br /> l. SUBTOTAL of Pernut 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 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 /> all work in strict accordance with the ordinances of the City and the regulations of the State of <br /> Minnesota, and ertifies that all statements made on this application are,true and correct. <br /> ,// � l <br /> A licant: � /���7' " — � — �� <br /> pp Date: � / <br />