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�.,. <br /> FOR CITY USE ONLY <br /> O Cit of Orono t.. � <br /> � � P.O Box 66 Date Received: " � �Permit# �� .� ��� �? <br /> 0 2750 Kelley Parkway <br /> Crystal Bay,MT�I 55323 Approved By:(If Required): ' �� <br /> (952)249-4600 � <br /> � Z • �� �� <br /> yF <br /> �qkFSNO��.�' 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 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 /> "�] New Meter ❑Additional Meter—For: ❑ Replacement Meter <br /> Job Site/Owner Information: <br /> Site Address: ��� S`'"�5�'w� C�� <br /> Owner: Mailing Address: <br /> City: �1 G�a �o Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> Contractor: �'+��s��•� i��v��%s Contact Person: /"�<k�- <br /> Address: `t�2� ����-� ��NGState License #: �G �4-��� <br /> City: S�,ll�a;C�ctL Zip: ����Expiration Date: (�� 3�-15� <br /> Phone: �b-3 ��`�7- 7'�l�3fo Alternate Phone: <br />