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F R C Y USE ONLY <br /> {� City of Orono � � <br /> rO�O P.O.Box 66 Date Receive :� Permit# � � <br /> 2750 Kelley Parkway <br /> Crystal Bay,MN 55323 Approved By(If Required): <br /> (952)249-4600 <br /> �F � <br /> �qkEs�{p���' CITY OF ORONO—WATER METER FORM <br /> (*Note:Some permits may require approval by the Building Official and/or Public Works Department <br /> +� <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 /> Job Site/Owner Information: <br /> Site Address: vr��' <br /> Owner: �.c�r' �_""�� 1� �� � � <br /> �-� �ilingAddress: �l/ ,��I ��� �e <br /> � <br /> City: � Zip: `�'�•�� <br /> � <br /> � <br /> � <br /> Home Phone: ��-':'�J—d��� Alternate Phone: �D%����j��� <br /> Contractor Information: <br /> Contractor: ,��i ,�,c,�.f�",�r.�,�!,,,,�� � Contact Person: � , <br /> Address: ��� ��� State License #: � /�j��j <br /> City: ���1.-r�.t� Zip� Expiration Date: �✓�j �1 <br /> Phone: J�.,7—j.�—���J� Alternate Phone: ���` '—�a��� <br />