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. � <br /> ��/ , � <br /> � � <br /> FO�Y USE OiVLY <br /> O City of Orono � �/' z� /� <br /> �- �O P.O.Box 66 IIate Reeeiv�� Perrnit# �/,�/�7— v ` <br /> 2750 Kelley Parkway <br /> Crystal Bay,MN 55323 Approved By:(Ifiiequired): <br /> (952)249-4600 <br /> ��`�kEs o�``G� CITY OF ORONO-WATER METER FORM <br /> H (Note:Some perm�ts 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 lrnow 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 PERI�IT'T' <br /> Cheek All'That A I <br /> �Residential(May Require Approval) ❑ Commercial(Approval Required) <br /> / <br /> �.New Meter ❑Additional Meter—For: ❑ Replacement Meter <br /> Job Site/Owner Info�nation: <br /> Site Address: ��C� ��„��, t, �,�� � <br /> .-.—r <br /> , �, <br /> Owner:�2.�cr,�1-�-�6� c-S'�' ��'%� Mailing Address: �,j��S (vS ��/!� <br /> c��y: l�'l�-,�/�P ��r�,�e z�p: ��s�%l <br /> Home Phone: `7� �-�5� � .���U Alternate Phone: <br /> Contra�tor Iriformation: <br /> Contractor: 1 �, (�LC Contact Person: �Gf� C.d� <br /> Address: �4y1 ��,,?�J,�.-� .�� State License #: A�l1�����i�/"7y <br /> � �`5�°% <br /> City: ".� H' Zip: ��, Expiration Date: _f�- .�/ -- �� <br /> � <br /> Phone: �-��� Alternate Phone: ��� -���--��� <br />