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FOR CITY USE ONLY <br /> �O A' City of Orono <br /> 1 y P.O.Box 66 Date Received: Permii# <br /> � 2750 Kelley Pazkway <br /> Crystal Bay,MN 55323 Approved By:(If Required): <br /> (952)249-4600 <br /> �� � <br /> �qkFSH�4�C' CITY OF ORONO—WATER METER FORM <br /> (Note:Some permits may require approval by[he 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 /> �New Meter ❑Additional Meter—For: ❑ Replacement Meter <br /> a� <br /> Job Site/Owner Information: <br /> Site Address: ���� ��t�/lDt, (�,I�' <br /> Owner: �WY�b� �°X�.�P1�n�,o,�� Mailing Address: <br /> City: ���I(1,1� Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> Contractor: �p����UW�� Contact Person: 0(� <br /> � <br /> Address: �(2"� ���,�1'1i�C.v, State License #: �V�0�J�� 1� <br /> � <br /> City: l Zip: 1�J3�b Expiration Date: Z� �i � �� � <br /> Phone: 7�O� `'r�7• 7`E�� Alternate Phone: <br />