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r • <br /> A <br /> , <br /> FOR C USE UNLY <br /> � , City of Orono � Z � � <br /> �0� P.O.Box 66 Date Received: I�?enmit# ,�,,, '�' � <br /> � 2750 Kelley Parkway � <br /> Crystal Bay,MN 55323 Approved$y:'{If Rcquirod}; �'�-��,,,;,,�,,,�, <br /> (952)249-4600 <br /> �`�� �,�� CITY OF ORONO—WATER METER FORM <br /> �'�ES H O� <br /> (Note:Some permiu 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 osn sible,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 /> :: T�FE 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 /> Job Site/Owner�nfozmation: <br /> Site Address: �—T�>c�v1�, � ��✓1� <<�C �� <br /> Owner:.S � �►'1� �u`� !J'^� '��C�'S Mailing Address: <br /> City: d rD�I) Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor Infarmati�n: <br /> Contractor: ����� �d✓1 I lU►�►��� lcx Contact Person: /� � � <br /> Address: ��� Z � �'1�C��t�17_, � State License#: <br /> L��r� �� <br /> � � ��2,� <br /> City: J Zip:�� 1-�� Expiration Date: <br /> Phone: Tb3 — ����- -�y�� Alternate Phone: <br />