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' - L <br /> r. �� �a � � :z � � � ��t � <br /> >���� �g,�� � ��� �� ti� t � � ' ,��EES ����a"� ' � � �'' � �,5��� <br /> � '. � � .� � � � �� ��,���� � <br /> ; : <br /> � � � <br /> � T��� ..�r'w ��. �r�� ,�s� .� � h A�`ED�����ITI�'�STAFF��;'� ��`�� ��5"��`�,�� <br /> �S/8"METER- ❑ 3/4"METER- � 1"METER- <br /> ❑ 5/8"HORN - ❑ 3/4"HORN - ❑ 1"HORN - <br /> ❑ "WATER METER (THESE WILL HAVE TO BE SPECIAL ORDERED&PRICES DETERMINED) <br /> 1. METER FEE: $ <br /> 2. HORN FEE $ <br /> 3. TOTAL PERMIT FEE(Add Lines 1-2 Above) $ <br /> CITY-USE ONLY <br /> * For Current Pricing Refer to Current Year-Water Meter Pricing Chart * <br /> Bx�,r�: JV-� ��'-I�IVv�-- <br /> SIZE: �5/8" ❑3/4" ❑ 1" ❑Other " <br /> SERIAL#: g`l 8�5 1 03 <br /> ERT HIGH#: �������������������� (if applicable) <br /> ADDITIONAL INFORMATION—WATER METERS <br /> The undersigned hereby applies to the City of Orono for issuance of a water meter permit, agrees <br /> to do all work in strict accordance with the ordinances of the City and the regulations of the State <br /> of Minnesota,and certifies that all statements made on this application are,true and correct. <br /> Applicant: Date: Z' Z 2 � � <br /> , �� ������ ���� � <br /> # ��Res�et�Fo�m����� <br /> !'�` '1 b � <br /> s .,.�3��`..�'`.���a�'c.t��'' ..,,,..� <br /> Original: 1-Address File <br /> Make Copies For.• I- Utiliry Billing Deparhnent 1-Cash Drawer <br />