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FQJ t~ITY VSE ONLY <br /> O- , City of Orono <br /> P.O.Boa 66 •-Date lfeeedved •„' /313 <br /> 2750 Kelley Parkway <br /> t t , ',jjj Crystal Bay.MN»323 21� roved$y �If ��utred) <br /> ' (952)2494600 "" ` � <br /> CITY OF ORONO—WATER METER FORM <br /> y+, (*Note:Some permits may require approval by the Building Official and/or Public Works Department*) <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 meter installation. <br /> ' t4 ° ORPM 1: <br /> ..• .., ¢. .-. t y� ate ,>.. ' <br /> E Kesidential(May Require Approval) ❑Commercial(Approval Required) <br /> New Meter fl Additional Meter—For: ❑ Replacement Meter <br /> Site Address: —10 1 1.)l I._U_,IC.t. stY1 Yt <br /> Owner: Mailing Address: <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> x <br /> Contractor: ' fJ i /?7 Mt)*w 1.(4 ) Contact Person: ,Ji <br /> Address: I cj53►- a I',I , State License#: Pe1/146341 <br /> City: il)WIDaii41 Zip:64t4 Expiration Date: 12.31• Z617 <br /> Phone: `11j • 113 22.1,1 Alternate Phone: 1f/3•2.56.q-itt <br />