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' . <br /> w ; <br /> "' �`"`� D�TERIVIINiNCSr P�RI�IIT.;FEES `` �' ' �` , ,�� <br /> ;� �� =;'� �, . .�� ,f ti <E,. <br /> . .;.... ,...,� ,s . . ..,<< ,., _ _ .., <br /> ❑SAC Charge(2005 Rate=$1,550.00) $ <br /> (SAC Charge must accompany all sewer pernut applications unless prepaid) <br /> (Orono City Staff can detemvne if applicable) <br /> (If not prepaid,a sewer connection permit will not be issued) <br /> �Sewer Connection/Disconnect/Repair($35.00/Per Stub) $ J J' �O <br /> Pi pe size�inches;material�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 /> O� <br /> 1. SUBTOTAL of Pernut Requested: $ �� � <br /> 2. STATE SURCHARGE $ .50 <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applicarions) $ 1.50 <br /> 5� <br /> 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) S �� <br /> 'ADDITIONAL INFORMATION—VJATER 1VIETERS <br /> ■ WATER METERS must be picked up and paid for at Orono City Hall,these are on a senarate 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 certifies that all statements made on this application are,true and correct. <br /> Ap�licant: Date: �/Z�l� <br />