|
02/27/2018 09:27 7632592299 SCHULTIES PLUMBING PAGE 02/05
<br /> .
<br /> ��A, City of Orono � ��'� ' � .�/-�
<br /> {V/'� P.O.ROX 66 1�DNte�ta�� �v,�....,���.] ' �/ �
<br /> ��✓ I750KE��CYP�kway � ;JrccmiS,iF•��f��''�.. W�
<br /> St6I A MN 55323 ' , " '',, r",;,'
<br /> Cf5' sy ,`.,�. . . .�;1�'�;���''"" �„ I,I�;,�,,;,
<br /> (952}249-0600 �V `;.:a�',�� ,,r�..:...W'i�.,;.,
<br /> ;, ''r.,y;
<br /> � � ' . ��1�: ���II�.'1��� "�r.��.'li:r'�.i��i�,i�.��'i..�.'�;�
<br /> � il�,���..!:'i��.���',"�i:.1.� "�1. �Ill.�l�i���;.
<br /> 1
<br /> ��+��s�oa�' CT'�'Y O�'4RONQ,WATE�t ME7'ER FORM f
<br /> (Kote;Some pem�i�a may rcquir�appro�al by the Huitding p('f'�c;al and�or Publia Works lkparsment)
<br /> ,, ..:: .... .. . . . .
<br /> , .
<br /> „. , . ,�;,:,, , ., , � ,
<br /> ,,..,....
<br /> ,.� � . , ,,.:. ,
<br /> ,. . - ; , ., . :': :�„„ �:,;;;,:c .:nr,��, �:;�,;,.
<br /> . � . �. . : . ...�,..�. .I .:�i:�.,r'.,,.. .
<br /> ....�,:' ..r.��:.�..
<br /> �....
<br /> �',
<br /> , . .i.� . .�.,..�....... ..:.:... ... � � ' ." ��i '.I,'
<br /> �,��:.,..:..,..�n,....� �r� v.;,:�
<br /> � •
<br /> �,..
<br /> . ... . .�.��a,..,.,. ..... ...,.,.d;v
<br /> ]. WATER M�TERS must be picked up and paid for at City i�a1I.
<br /> 2. If��ible,fgx in this applicatioe ahead aftime;we wili t(ten cail you tutd let you knowwe have
<br /> thc water meter in stock_ ,Fax Numbe�r;(952)249-46I6. AIso,you ean ca11 ahead oftime to make
<br /> sure we receive�the fax,or to warn us that the fax is con�ing.
<br /> 3. R'ATEXt METERS m,ast be set �nd sealed by Orono WAter Department (952) Z49-4600,
<br /> u�op eomplet�on af ineter 9nstallation.
<br /> ;,;;;,;,:,;,,, ,,,,,�:,�,.,..,,
<br /> �,...;,. .... ,�,
<br /> ,.,,, . .
<br /> '"� �,�tr.,;':.�,:�.�..,:�.,.,�� �� �d'� �i .
<br /> ' ..,'�/��;�� '
<br /> ,
<br /> �.�..�. ..,., .
<br /> .. . . �.�;�.�::,,i��..�„n��:pa:;';�,�:�.;�....�..,,'�� �..iC ,�
<br /> "�"ril'����.:,��..�a,�������;�n:.���.,���,..,,, �....� ���i�,,:i;:�,�., ���� .
<br /> ,,.,, ...,, �,:�.,.����. ...��. �..��
<br /> ; ,.
<br /> �.
<br /> „ �..
<br /> �r,..���:,, .. ���,,,..�,�,,.::I� . . „�!;:���,��;;.'� ......�,�����.n, ;.;i; ;;��.li�
<br /> ,.., -. . .
<br /> .,...����,. :: ��, �.:�: .� .� �, , ; .., . ,.. ..;. .ii'..�.'., :;:.,...... '.. ,.
<br /> � ��. , : "' . .� . "., .. ::���:.�:i.�.�,���..�..�. ,.��������: �;.ii�j�l' :.,
<br /> .��i � ��i . . .., �r.c��i.�;:{!f�l„��n,��..;, ,,p�nl��i�����:..
<br /> � .
<br /> . .. . �.�...,,� .,.,,�
<br /> � " �,..;.e .�.�.��.o.,.,...�.,:..�....�.. .��a . ..
<br /> ��� � ...
<br /> �' . .. :. ...... :....'�.�! � . i
<br /> ; ......::.:....:. ....:. ',�1;�C�'�1,�'�]
<br /> ..,..,;:: .�:„,�.,
<br /> „ . ,:::.,,
<br /> ,
<br /> , . ,,.. . .
<br /> �..
<br /> ,......,..,
<br /> .. �t.;. , i.. . , ,.
<br /> ,,,
<br /> ,,.,,.
<br /> �Residential{Msy Require Appro�al) ❑Commercial(Approval Reqaired)
<br /> �.New Meter ❑AdditionA]Meter�-For;
<br /> ,�, ❑Replacoment M.eter
<br /> '��'a'�':'�?��''.�J►,'�tii�ai�:��t��:
<br /> Site Address: 7�
<br /> Owner: Mailin.g Address: �2L1�/ � �G�
<br /> City: ���� �
<br /> _, Zip: ��
<br /> Home Phone:������'�,��!� p�ternate Phone:
<br /> �'WIVlf���y P
<br /> ��,
<br /> Contractor: Contact Per�n:
<br /> Address: � �7`� 5tate License#:
<br /> City: , Z7�7� Expiration Da.te: �
<br /> Phone: '"/��` AlternatePhone:
<br />
|