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FOR CITY USE ONLY <br /> c <br /> o*0% <br /> City of Orono <br /> P.O.Box 66 Date Received: Permit# <br /> 2750 Kelley Parkway <br /> .r Crystal Bay,MN 55323Approved By:(If Required): <br /> • v (952)249-4600 <br /> y�ao��' <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 /> (Check 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: j2- C „ / 6 /f-- <br /> Owners i.e-/ Mailing Address: f3-0 "7----; ,, <br /> City: C2..t '�` Zip: <br /> Home Phone:7�2-- '96 - 2-6”i Alternate Phone: /2 & 9 73-3--/J' <br /> Contractor Information: <br /> Contractor .),„ -A✓ JE 2/i ontact Person: _ .... /- _, <br /> Address: 7f2-ZV 7/�e-z-, 4` State License #: 0 577 L It "`)--- <br /> City: �� <br /> ., J Zip:c.537Axpiration Date: /7 - 7/" 0 <br /> Phone: � ; 7 75-6 47,7 Alternate Phone: /.7Z -'/7'--,/q ( <br />