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, <br /> .. . . <br /> .,.; . . . _ <br /> �� �, `��< < ' � ' 't'•` DETERIVIININC�P�RlulIT;FEES ::� ;'f� ,'`�' �;� <br /> � � �, i , , <br /> ❑ SAC Charge(2005 Rate=$1,550.00) $ <br /> (SAC Charge must accompany all sewer pernut applications m.iless prepaid) <br /> (Orono City Staff can deternv.ne if applicable) <br /> (If not prepaid,a sewer connection permit will not be issued) <br /> Sewer Connecti Disconnect_/�epair($35.00/Per Stub) $ <br /> � � �... <br /> Pipe size incZie§;n�atenal Schd 40 air tested; cast iron <br /> ❑Water Connection/Disconnect/Repair($35.00/Per Stub) $ <br /> Pipe size inches;material Schd 40 air tested; copper <br /> 1. SUBTOTAL of Pem-ut Requested: � <br /> 2. STATE SURCHARGE $ .50 _ <br /> 3. POSTAGE&HANDLING(Only on Mail-I�l Applications) $ 1.50 <br /> 4. TOTAL YERMIT FEE(Add L'uies 1-3 Above) $ <br /> ' ' '�ADDITIONAL Il�FORMATION—vWATER 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 strict accordance with the ordinances of the City and the regularions of the State of <br /> Minnesota,and certifies that all statements made on this ap�lication are,true and co�ect. <br /> A�plicant: Date: � Z 2 �� <br />