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� ,:, . ,. . .: .... � <br /> , . � j ; , , fi ,,'''� ' D�TERMININ.,C���RMIT;;FEBS� '` ��` ' .�.:; ' r' f`§;r a,; <br /> ?, - <br /> �AC Charge(2005 Rate=$1,550.00) $ <br /> (SAC Charge must accompany all sewer pemut applications unless prepaid) <br /> (Orouo City Staff can determine if applicable) <br /> (If not prepaid,a sewer connection permit will not be issued) <br /> �wer Connection/Disconnect/Repair($35.00/Per Stub) $ <br /> Pipe size inclles;material Sclid 40 au tested; cast iron <br /> ❑Water Connection/Disconnect/Repair($35.00/Per Stub) $ <br /> Pipe size uiches;material Schd 40 air tested; copper <br /> 1. SUBTOTAL of Perniit Requested: $ <br /> 2. STATE SURCHA.RGE $ .50 <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applicadons) $ 1.50 <br /> 4. TOTAL PERMIT FEE(Add L'uies 1-3 Above) $ <br /> ' ADDITIONAL Ii�FORIvIATION—WATER 1VIETERS" <br /> ■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a separate 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 sh ict accordance with the ordinances of the City and the regulations of the State of <br /> Minnesota, and certifies that all stateinents made on this ap�lication are,true and correct. <br /> �? - r <br /> Applicant; �./-��� Date: ,� " Z f - d� <br />