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FOR CITY USE ONLY <br /> City of Orono <br /> P.O.Box 66 Date Received: Permit# <br /> 2750 Kelley Parkway <br /> t� Crystal Bay,MN 55323 Approved By:(If Required): <br /> v (952)2494600 <br /> �so$� <br /> CITY OF ORONO—WATER METER FORM <br /> (*Note: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 meter installation. <br /> TYPE OF PERMIT <br /> Cheek All That Apply) <br /> Residential(May Require Approval) ❑ Commercial(Approval Required) <br /> ❑ New Meter ❑Additional Meter—For: .'Replacement Meter <br /> Job Site/Owner Information:' <br /> Site Address: �� �� �.� \ U C) <br /> Owner:P,�"k 1 l C�� �\� Mailing Address: 36&o TUBO <br /> City: (Vac) Zip: E53V <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> Contractor: Contact Person: <br /> Address: State License#: <br /> City: Zip: Expiration Date: <br /> Phone: Alternate Phone: <br />