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V <br /> F R C USE ONLY <br /> �O A T City of Orono ei �f / <br /> 1 V P.O.Box 66 date Receid� � Permit#VC.Q v'� ✓1�—" <br /> 0 2750 Kelley Parkway <br /> Crystal Bay,MN 55323 Approved By:(If Required): O <br /> (952)249-4600 4 ��' <br /> ` kESH0 CITY OF ORONO WATER METER FORM <br /> (*Note:Some permits may require approval by the Building Official and/or Public Works Department <br /> s) <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 /> JobSite/ Owner Information: <br /> Site Address: ✓ / O ° <br /> c o c f <br /> Owner: Mailing Address: ° <br /> City: Zip: <br /> Home Phone: �I�2 '`f �'qU "7 " 1 Alternate Phone: l.�tZ' 3 D'Jo'y44 <br /> Contractor Information: <br /> Contractor: Contact Person: <br /> Address: State License#: <br /> City: Zip: Expiration Date: <br /> Phone: Alternate Phone: <br />