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� <br /> FOR CITY USE ONLY <br /> City of Orono t1 � �!�' <br /> �O�O P.O.Box 66 Date Received: 1`,�Permit# �� " �,� f <br /> 2750 Kelley Parkway <br /> Crystal Bay,MN 55323 Approved By:(If Required}: ° <br /> (952)249-4600 <br /> � � <br /> � � <br /> `�kESHO��G CITY OF ORONO-WATER METER FORM <br /> (Note:Some permits may require approval by the Building Official and/or Public Works Department) <br /> GENERAL 1NFORMATION <br /> 1. WATER METERS must be picked up and paid for at City Hall. <br /> 2. If nossible, fax in this application ahead of time;we will then call you and let you know we have <br /> the water meter in stock. Fax Number:(952)249-4616. 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 O�PERMIT <br /> Check All That A 1 <br /> /J/�` Residential(May Require Approval) ❑ Commercial(Approval Required) <br /> i � <br /> �New Meter ❑ Additional Meter—For: ❑ Replacement Meter <br /> Job Site/Owner Information: <br /> Site Address: � ��i.� �.� � � <br /> Owner: Mailing Address: <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> Contractar: `�����h ��.� ��-F«� '� <br /> � Contact Person: � � <br /> Address: �1,�y M�i��,��� ��'�'� State License #: �C �����o <br /> City: ���r��� Zip:�� Expiration Date: I ��j'�� <br /> Phone: ���''��Z 7- 7�� Alternate Phone: ��� -��l7"7��� <br />