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[ ser <br /> r1 <br /> avow, <br /> ❑ 5/8"METER- ❑ 3/4"METER- 1"METER- <br /> ❑ 5/8"HORN - ❑ 3/4"HORN - ] 1"HORN - <br /> ❑ "WATER METER (THESE WILL HAVE TO BE SPECIAL ORDERED&PRICES DETERMINED) <br /> 1. METER FEE: $ D <br /> 2. HORN FEE $ `O <br /> _ <br /> . 3g <br /> 3. TOTAL PERMIT FEE(Add Lines 1-2 Above) 99, $ d <br /> CITY-USE ONLY <br /> * For Current Pricing Refer to Current Year-Water Meter Pricing Chart * <br /> BRAND: <br /> SIZE: ❑ 5/8" ❑ 3/4" , f1" ❑ Other <br /> SERIAL#: ill 111111111I II III11111111111 <br /> 1820457186 <br /> ERT HIGH#: a57 39'O8 51 (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: � t/ G� — ��v Date: //--/ <br /> Original: 1-Address File <br /> Make Copies For: 1- Utility Billing Department 1-Cash Drawer <br />