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r <br /> � <br /> F R CI ' USE ONLY <br /> O City of Orono 9 �j <br /> �- � P.O.Box 66 Date ReceiJ� _,�Permit# b/(p —O /I l / <br /> � 2750 Kelley Parkway <br /> Crystal Bay,MN 55323 Approved By:(Ifitequiredj: <br /> (952)249-4600 <br /> ���-s,�E o���'� CITY OF ORONO—WATER METER FORM <br /> S H (riote:Some permits may require approval by the Building Official and/or Public Works Department) <br /> GENERAL INFORMATION <br /> 1. WATER METERS must be picked up and paid for at City Hall. <br /> 2. If possible, fax in this application ahead of time;we will then call you and let you know we have <br /> the water meter in stock. F�Number:(952)249-46]6. Also,you can call ahead of time to make <br /> sure we received the fax,or to warn us that the fax is coming. <br /> 3. WATER METERS must be set and sealed by Orono Water Department (952) 249-4600, <br /> upon completion of ineter installation. <br /> TYPE(3F PERMIT <br /> Checic All That A 1 <br /> �sidential(May Require Approval) ❑ Commercial(Approval Required) <br /> �ew Meter ❑Additional Meter—For: <br /> ❑Replacement Meter <br /> Job Site/Qwn�r information: <br /> Site Address: �� <br /> Owner:�� ��'�'(z._ Mailing Address: <br /> City: ��=s✓IW Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> Contractor: �;��y�j� ��, Contact Person: _�L� S <br /> Address: �-E1,�-� ��"�u� C.�- State License#: �t�2�-�� C��ti'� <br /> � <br /> City: +� Zip:j�� Expiration Date: <br /> Phone: �" Alternate Phone: �7(�3�'�-�(�--7�:� <br />