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..r. <br /> . FOR CITY USE ONLY <br /> City of Orono <br /> �O� P.O.Box 66 Date Received: � Z`'����Permit# �(�� � `� <br /> � 2750 Kelley Parkway <br /> Crystal Bay,MN 55323 Approved By:(If Required): �� <br /> (952)249-4600 <br /> y �. Ci iC C:-�S`3 �% <br /> � � <br /> ��'�ESH���G 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 /> TI'PE OF PERMIT <br /> Check All That A 1 <br /> �'Q Residential(May Require Approval) ❑Commercial(Approval Required) <br /> r � <br /> ,�f New Meter ❑Additional Meter—For: ❑ Replacement Meter <br /> �� L <br /> Job Site/Owner Information: <br /> Site Address: � C>C�� �% S G�c� (�� t.,J �.�-%C� <br /> Owner: Mailing Address: <br /> City: �i(�U ��- �% Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> ' ' /s�� <br /> Contractar: C�, ,�(,s�,� ���-,.�'�Contact Person: � � �� d� �' � <br /> Address: 1�,,� �/v S� T`t�2 S �tate�icense#: - c� G <br /> City: �`�.j� �E' �"�'-°-'� ZipS,�Expiration Date: � �- �/ �- �� <br /> (S( �`1/- ]7�f <br /> Phone: ) Alternate Phone: <br />