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.� • <br /> � <br /> � �� o , � � <br /> } � � � 9 <br /> � <br /> CIT' USE ONLY <br /> fO� � � City of Orono � �) �-j�(,� <br /> gr`�0�� P.O.Box 66 Date Receiv �% '/ Permit# O�(�/l— (/ / <br /> ��� ,,�.,.,,,_ rI 2750 Kelley Parkway <br /> S� ����. 1�� Crystal Bay,MN 55323 Approved By:(If Required): <br /> �\����`,r�.�,�yy� (952)249-4600 <br /> \�=K� <br /> 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 /> �New Meter � Additional Meter—For: � Replacement Meter <br /> i <br /> Job Site/Owner Information: <br /> Site Address: �`rU S�k'�'�S��Q Li✓ <br /> Owner: Mailing Address: <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> �u' � <br /> Contractor: � �G Contact Person: � /' <br /> Address: 1-� �� �� �✓��� State License #: �6�3��--�/► � <br /> City: �� Y�Q2�[ Zip:sS��/ Expiration Date: .?� ��joL <br /> Phone: �](�,���,�r�j�:S73`� Alternate Phone: �G� ����7(a P <br />