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FOR CITY USE ONLY <br /> City of Orono <br /> �-��O P.O.Box 66 Date Received: Permit# <br /> 2750 Kelley Parkway <br /> Crystal Bay,MN 55323 Approved By:(If Required): <br /> (952)249-4600 <br /> � � <br /> ti ` <br /> `� ��,�' CITY OF ORONO-WATER METER FORM <br /> `�kESH� (*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. I�ossible,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 PERIVIIT <br /> (Check All Tl�at A 1 <br /> ❑Residential(May Require Approval) ❑ Commercial(Approval Required) <br /> ❑ New Meter ❑Additional Meter—For: ❑ Replacement Meter <br /> 7ob Site/Owner Informafion: ' <br /> Site Address: L� � � ��F <br /> Owner: �a �� t�l `�C- � '^a� Mailing Address: ��'� �'�' � <br /> City: b�a,�. o Zip: '�� 3� � <br /> Home Phone: q'.�2 -y 7 1 - 1 2 i S� Alternate Phone: ��2 - ��'��'�-7 1 � <br /> Contractor Information: ` <br /> Contractor: Contact Person: <br /> Address: State License#: <br /> City: Zip: Expiration Date: <br /> Phone: Alternate Phone: <br />