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' DETERNIININGPERMIT FEES <br /> � SAC Cha►gc(2007 Rate=�1,G7�.00) � <br /> (SAC Charge must accompany all se�ver permit applications unless prepaid) <br /> (Orono City Staff can detcrmine if applicable) <br /> (lf not prepaid,a sewer connection permit will not be issuecl) <br /> �Se� er Connectio Disconnect/Repair(�35.00/Per Stub) $ �,� D O <br /> Pi ' hes; material Schd 40 air tested; 0 cast iron <br /> 01 ���ater Connection/Disconnect/Repair(�3�.00/Pcr Stub) $ <br /> Pipe size inches; materiai_ Schd 40 air tested; � copper <br /> 1. SUI3TOTAL of Permit Requested: $ <br /> 2. STf1TE SURCHARG� $ .�0 <br /> 3. POSTAGE&HAIvDLiNG (Oniy on Ylaii-In Appiicacions) S 1.50 <br /> �0. TOTAL PE6ZlYI1T�EE (Add Lines 1-, Above) $ <br /> ADD[TIONAL INFORMATION —WATEK NI�TERS <br /> � ��'ATER��IG7'ERS must be picked up and paid for at Orono City Hall,thcse are on a separate�ermit. <br /> � �VA'['�R 1�1�TERS m�ust be set �nd sealed by Orono «'ater Dep�rtment {9�2) 2�19-dG00, upon <br /> completion of ineter installation. <br /> The undersigned hercby applies to the City of Orono for issuance of a Utility Permit, agrees to do <br /> all ���ork in strict accordance �vith the ordinances of the City and tlle regulations of the State of <br /> Minnesota, and certifies that all statements made on this application are, true and correct. <br /> Applicant: ����/y�� Date: ��`l �! <br /> Reset Form <br />