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>R CITY L➢.li%[lVi.Y <br /> n A TO City Orono <br /> P.O.Box <br /> 66 Dgft Received: Pit# <br /> 2750 Kelley Parkway <br /> Crystal Bay,MN 55323 AWwmd By:(ifRetluirea): <br /> (952)249-4600 <br /> `�kE SHO <br /> IQ, CITY OF ORONO-WATER METER FORM <br /> (Note:Some <br /> (N 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 /> Check All That Apply) <br /> ,EgResidential(May Require Approval) ❑ Commercial(Approval Required) <br /> ANew Meter ❑Additional Meter—For: ❑Replacement Meter <br /> Jab Site/Owner Information: <br /> Site Address: S kA(,j.4 L,,,&oN C, r—�_ <br /> owner:�'�w�-�� G.�w� Mailing Address: ✓l <br /> City: Zip: <br /> Home Phone: &r Z &S 9 / 3L- Alternate Phone: <br /> Contractor Information: <br /> Contractor: Contact Person: <br /> Address: I 1(.0 �'�C-�cr .4uc: -,C- State License #: ac 60,490,f f., <br /> city: Zip: 3 Expiration Date: IZ-t l - 11 <br /> Phone: (o(Z- 'zoz-S 0`< ( Alternate Phone: <br />