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.. <br /> � <br /> i 1 � �� DETERIYII.�FINC� � - � '� ti . -�Frr &�' �- <br /> � ��� �� �:�� P.ERMIT FBES; }� ,._: � M; <br /> ; , , <br /> �- -� , . � . , <br /> ❑ SAC Charge(2005 Rate=$1,550.00) $ <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($35.00/Per Stub) $ <br /> Pipe size inclies;material Schd 40 air tested; cast iron <br /> ❑Water Connection/Disconnect/Repair($35.Q0/Per Stub) $ <br /> Pipe size uiches;material Schd 40 air tested; copper <br /> 1. SUBTOTAL of Pennit Requested: $ <br /> 2. STATE SURCHARGE $ .50 <br /> 3. POSTAGE&HANDLING(Only on Mail-In A�plicadons) $ 1.50 <br /> 4. TOTAL PERMIT FEE(Add L'uies 1-3 Above) $ <br /> : , , . <br /> ADDITIONAL Il�'FqRMATION—WATER METERS <br /> ■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a seuarate pernut. <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 shict 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 coirect. <br /> ( . � ,� z _d <br /> Applicant:��2�—` , ��� Date: �✓ � � <br />