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FOR CITY USE ONLY <br /> ��� City of Orono .�(��� �� � � <br /> O P.O.Box 66 Date Received: �� ��' Permit# '�'r <br /> 2750 Kelley Parkway <br /> Crystal Bay,MN 55323 Approved By:(IfRequired): <br /> (952)249-4600 <br /> �� � <br /> `�kFSH�R�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 iNFORMATION <br /> 1. WATER METERS must be picked up and paid far 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. 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 OF PERMIT <br /> (Check All That A 1 <br /> �Residential(May Require Approval) ❑ Commercial(Approval Required) <br /> ) <br /> �ew Meter ❑ Additional Meter—For: ❑ Replacement Meter <br /> Job Site/Owner Infonnation: <br /> �' ��� � <br /> Site Address: ,.� �-►^- ti-�- � � /� <br /> �� <br /> Owner: Mailing Address: <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> Contractor: /!�«lS�o� �1��� r�+ Contact Person: �/�����-�-- <br /> Address: 7l�� f��a?r�- c�`ti�State License #: �C ����� <br /> City: .�I'Tc��� Zip�� ExpirationDate: �� " r "� <br /> r <br /> Phone: '7�c3��'f 7- 7�Q� Alternate Phone: ����4 7- 7� <br />