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�"�,f�.�-��� __x��t�l�� �-1,�-l�l <br /> F`OR CTfY USE QNLY <br /> ,�O A T City of Orono <br /> 1 V P.O.Box 66 Date Rccsived:. ,��J.3"r Pe�nit# �-�C% 7-G �.'�<' <br /> � 2750 Kelley Pazkway <br /> � Crystal Bay,MN 55323 Agproved By:(If Required): `..��' <br /> � � (952)249-4600 <br /> �� � <br /> `q'F�SH���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 INFORMATIOI�1 <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)249-46]6. 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(JF PERIV�IT <br /> Check All That A 1 <br /> ❑ Residential(May Require Approval) ❑Commercial(Approval Required) <br /> ❑ New Meter ❑Additional Meter—For: ❑ Replacement Meter <br /> Job Site/Owner Information: <br /> �j� Site Address: �����(9i'g' /� /V�L�LJ� �nU� <br /> � <br /> Owner: Mailing Address: <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> Confiractor Informatian: <br /> Contractor: �`�7 l ���i�,- Contact Person: ����� �!��j� <br /> Address: ��/� ���C State License#: <br /> City: �' � 't� Zip: 3�� Expiration Date: <br /> Phone: ���� �3�`'��� Alternate Phone: �`� '` �� (��- ��g� <br />