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� , - t <br /> � <br /> FOR CITY USE:ONLY <br /> O,¢��,0 City of Orono �i' <br /> P.O.Box 66 Date Receive�,��d����CPermi## <br /> 2750 Kelley Parkway <br /> � t. ,M1 � Crystal Bay,MN 55323 Appraved By:(If Required): <br /> ° " (952)249-4600 <br /> �a�8o8� <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 PERMTT <br /> Check All That A 1 <br /> ❑Residential(May Require Approval) ❑ Commercial(Approval Required) <br /> ❑ New Meter ❑Additional Meter—For: Replacement Meter <br /> 7ob Site/Owner Information: <br /> Site Address: a�C�r'J J�' FI�A DYUIV O.V i'�.,V �R�N�, �11� 55 331 <br /> Owner: L1JdIV /yl/4'R.fE FU)( Mailing Address: 15A'1'�'iF� <br /> �—� <br /> c�ty: �FZ�N� z�p: �53�I <br /> Home Phone: ��{� �7�-- ��rDg Alternate Phone: <br /> Contractor Information: <br /> Contractor: i.UE[�D dr SON� Contact Person: ('ViftklC U�1/1� <br /> Address: 3'f I n K+L!►��R LN I�J State License#: <br /> c�ty: P�y mo u�� Zip: ��� Expiration Date: <br /> Phone: �l���t�1.�j'�Qo�q�j Alternate Phone: <br />