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{ DO, WATER METERPERMIT=FEES <br /> ❑ 5/8"METER-$240.00 /4"METER-$291.00 ❑ 1"METER-$356.00 <br /> ❑ 5/8"HORN -$ 44.62 ❑ 3/4"HORN -$ 49.03 ❑ 1"HORN -$ 73.12 <br /> ❑ "WATER METER (THESE WILL HAVE TO BE SPECIAL ORDERED&PRICES DETERMINED) <br /> av <br /> 1. METER FEE: $ r <br /> 2. HORN FEE $ / <br /> 3. TOTAL PERMIT FEE(Add Lines 1-2 Above) <br /> CITY-USE ONLY <br /> BRAND: <br /> SIZE: ❑ 5/8" k/4" ❑ 1" ❑Other " <br /> SERIAL#: C�> I © �J �0 0 <br /> 111918111811" <br /> ERT HIGH#: 1810272968 (if applicable) <br /> ADDITIONAL INFORMATION—WATER METERS <br /> The 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 /> Applicant: Q;e�� _b <br /> Date: <br /> Original: 1-Address File <br /> Make Copies For: I- Utility Billing Department I- Cash Drawer <br />