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�� <br /> r 1 <br /> �. <br /> ;.� �' <br /> ❑ 5/8"METER- Q 3/4"METER- 0 1"METER- <br /> ❑ 5/8"HORN - Q 3/4"HORN - ❑ 1"HORN - <br /> � "WATER METER (THESE WILL HAVE TO BE SPECIAL ORDERED&PRICES DETERMINED) <br /> 1. MET'ER FEE: $ <br /> 2. HORN FEE $ <br /> 3. TOTAL PERMIT FEE(Add Lines 1-2 Above) $ <br /> CITY-USE ONLY <br /> * For Current Pricing Refer to Current Year-Water Meter Pricing Chart* <br /> BRAND: � <br /> � <br /> SIZE: ❑5/8" �%4" ❑ 1" ❑Other " <br /> SE�.#: �ti�- �i � � ��s 9 <br /> ERT HIGH#: ����������������������������� (if applicable) <br /> 1820817364 <br /> ADDITIONAL INFORMATION—WATER METERS <br /> T'he undersigned hereby applies to the City of Orono for issuance of a water meter permit, agrees <br /> to do all work in strict accordance with the ordinances of the City and the regulations of the State <br /> of Minnesota,and certifies that all statements made on this application are,true and correct. <br /> 04/08/2010 <br /> Applicant: Date: <br /> + b i=°�,�s� <br /> � ;bi9 <br /> ;s � ,s <br /> y <br /> �;��, � %....,:. . . `a�`,.��<,. �����.;�''"k�s.w.sL� <br /> Original: 1-Address File <br /> Make Copies For: 1- Utility Billing Department 1-Cash Drawer <br />