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' FOR CITY USE ONLY (,' <br /> City of Orono /�F� <br /> O4�'�� P.O.Box 66 Date Received: Permit#� <br /> q'�s,�� 2750 Kelley Parkway 2007 <br /> � �y ,'�.� Crystal Bay,MN 55323 Approved By:(If Requ�red): <br /> ` (952)249-4600 G)= <br /> iat�o$` Qf V� <br /> 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 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 OF PERMIT' ' <br /> Check All That-A 1 <br /> ,�Residential(May Require Approval) ❑Commercial(Approval Required) <br /> (�New Meter ❑Additional Meter–For: ❑Replacement Meter <br /> I <br /> 7ob Site/Owner Information: , <br /> Site Address: 1X�2 \ S�j`� <br /> Owner: 2G�C�fi(l�,�/_`�� Mailing Address: <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> t---� ^_ —� <br /> Contractor: �SP-,� (�/(,,,h„��� Contact Person: � \1N-� �—v�PJ��o� <br /> � <br /> Address: �11����I l� State License#: 22l '� <br /> City: Zip9��� Expiration Date: �'�c 3� �7 <br /> Phone: Alternate Phone: �/l l�-��� 3 Z7�f� <br />