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� � <br /> FQR CIT USE ONLY <br /> � City of Orono �C/ <br /> �� �� P•O.Box66 DateReceivedJ��� Permit# UC� �9— ��5� <br /> �;;,.�,,, 2750 Kelley Parkway <br /> a ,���r;4�<,-'�. Crystal Bay,MN 55323 Approved By:(If Required): <br /> ���H�yc� (952)249-4600 <br /> CITY OF ORONO—WATER METER FORM <br /> (*Vote: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 PERMIT <br /> (Check All That Apply) <br /> �I�esidential(May Require Approval) ❑ Commercial(Approval Required) <br /> ❑ New Meter ❑ Additional Meter—For: ❑Replacement Meter <br /> Job Site/ Owner Information: <br /> Site Address: ��� 3� J���� � ' �� 1� r � <br /> Owner: ��m� S � �'�e�� � Mailing Address: ��S u ���r L�'v� t-'N <br /> c�ty: �IZ t� �� v z�p: 5-5-3 L �l <br /> Home Phone: ( S� ����� �1�� Alternate Phone: <br /> Contractor Information: <br /> Contractor: � l ( Q`��' � ` Contact Person: � ' � � <br /> Address: J��/n� �/9/� State License#: <br /> City: Zip: Expiration Date: <br /> Phone: �n 1� O / 7 ���� Alternate Phone: <br />