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_ ,,� <br /> a �w <br /> FOR CITY USE ONLY '` <br /> O,¢O�,O City of Orono <br /> P.O.Box 66 Date Received: Permit# <br /> " 2750 Kelley Parkway <br /> � � ,, � Crystal Bay,MN 55323 Approved By:'(If Required): <br /> �_ ` $y (952)249-4600 <br /> ��aa�o <br /> CITY OF ORONO—WATER METER FORM <br /> (*Note:Some permits may require approval by the Building O�cial 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 ossible,fax in this applicarion 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 FE1tMIT <br /> (Check A1f That� l ' <br /> ❑Residential(May Require Approval) ❑Commercial(Approval Required) <br /> ❑ New Meter ❑Additional Meter—For: �Replacement Meter <br /> Job Site/Owner Information: <br /> Site Address: � 9 7� S �°��y�✓'om� �� ' <br /> Owner: Mailing Address: <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> Contractor: %r/`es�Qtir� I�'��ecG.Co�,�'TnC Contact Person: ���an� �(Y�'r N ISo� <br /> Address: �sd� ��� �`1 �S State License#: <br /> City: m�'��^ � Zip:SS��� Expiration Date: <br /> Phone: ��2—y��,- '�19 S� Alternate Phone: �1`Z� 2 m 2�2$9 2, <br />