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F C Y USE ONLY <br /> i�oo City of Orono q /� <br /> O .P.O.Box 66 Date Receive . Permit# <br /> r 2750 Kelley Parkway <br /> rCrystal Bay,MN 55323 Approved By:(If Required): <br /> ' G,- (952)249-4600 <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 /> V(/) 11 57 <br /> (�'' Site Address: <br /> 5-- IA) • <br /> w(e,q <br /> Owner: Mailing Address: <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> Contractor: /15 (.4 T W A17 L Contact Person: f 2—' .i 0 Ai <br /> Address: f 4c 7-411-1?- (41-1( (20 State License #: PC 6 L/3 P"/ <br /> City: k7f Zip S�s->1 7 Expiration Date: I) - 3/ r13 <br /> Phone: /ca 'y� –5 41'J Alternate Phone: SAY/ <br />