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12/14/2006 16:42 7634131 027 T J CONCRETE PAGE 02102 <br /> +9822494616 <br /> T-104 P.002/002 P-800 <br /> • 4tt�� �7y�;f, �{ <br /> .IJIJ;4111'�3.—SR- �a !� <br /> 0 SAC C6 (2005 Rate�81,450.00)(SAC Charge $ <br /> � all sewer <br /> ue permit <br /> applications unless Cry Staff eau accompany <br /> applicable)not prepaid,'a sewer c a�permit pe d <br /> will not be Issued), <br /> Sewer Connection/Disconnect/Repair(S35.00/per Stub) <br /> Pipe size 4�!inches;materialSchd 40 air tested; cast iron <br /> fC j ater Connection/Disconnect/Repair035.00/Per Stub) <br /> • y Pipe size inches;materialSchd 40 air tested; cast iron -�—� <br /> 1, SUBTOTAL of Permit Requested: <br /> S � J <br /> 2. STAT SURCHARGE <br /> S <br /> 3. POSTAGE&HANDLING(Only on Mail-In Applications) <br /> d. TOTAL PERMIT FEE(Add Lines 1-3 Above) SO <br /> ,- cV <br /> • WATER METERS must be picked up and paid for at Orono City Hall, <br /> • WATER METERS must be set addsealed by Orono Water D p these t ( 5 a <br /> completion of meter installation, eP en (952) 24g g600� n <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 <br /> Minnesota,end certifies that all stat7rits made on this a.,. - and the rtrulationc of the State of <br /> .,. are,tine and coned. <br /> Applicant; 'L 1 lR /�• /► rate: l J4 IV�, <br /> f <br />