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12/17/2015 09:57 7632592299 SCHULTIES PLUMBING PAGE 04/07
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<br /> �# s�aa CITY OF QRONO—WA'�'ER 1V�,1'��Fpg�
<br /> (Note;3omc penuitn m�y roquire approv�by ihe Buildin�q p}�"rci�l attd/ar Publio Wp��cM)
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<br /> 1.. WA,T'ER.MET'EitS mast bc picl�ed up and paid for at City T-�all.
<br /> Z• I._f po ' le,fax in this app[ication ahead of time;we wi]1 then call yov artd let you krrow we.hav�
<br /> the'water meter in stock Fax Numbeir:(952)249-4616. Afso,you can calt ahead oftime to malce
<br /> sure w�received#h,e fax,or to warn us that the ftuc is coming, •
<br /> 3. WAT�R Nf�TER6 must be set and sealed by Ornno W:te�r Department (952) Z49.�46pp,
<br /> upon cona�le�tion oimeter insraAation.
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<br /> f Sf Residcntial(May Re�uire Approval) ❑Camincrcial(Approval Required)
<br /> �New Meter ❑Additiot�al Meter—For;
<br /> ❑Rcplacerncnt Meter
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<br /> Site Address:
<br /> ���� / � ����Mailing Address: ��J �� /� � �����,
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<br /> City: 7�p: �
<br /> Ho�ne Ph.one: � Alternate Phvae: -,�j f/�
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<br /> Contractor: �r " Contact Person:
<br /> A,ddress: State I '
<br /> ,iccnse#:
<br /> ���': � 7�P�' �xpiration bate:
<br /> Phone: �7���`!M�j� A,ltern.ate Ph�one: � c� .-�
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