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\ <br /> t <br /> F RCI Y USE ONLY <br /> City of Orono 3 V 1/—06. /W <br /> O¢ 4. City <br /> P.O.Box 66 Date Receive . / �( Permit <br /> r,t,, 2750 Kelley Parkway <br /> q4.t,,,- Crystal Bay,MN 55323 Approved By:(If Required): <br /> V.i , c (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 /> /21 Residential (May Require Approval) 0 Commercial(Approval Required) <br /> pNew Meter fJ Additional Meter-For: ❑Replacement Meter <br /> Job Site/Owner Information: <br /> Site Address: � Z),_..71--- 4-3c-----?"- Z A- �-y 7-l' A <br /> Owne41J ,-, V Mailing Address: ,0(.5- <br /> City: -?(C. ---l_.....-4/.4,--- <br /> City: -?C' Z,�5,i 4,-- Zip: __:353/ ` 7:257. <br /> Home Phone:9\L &10 34,2 Alternate Phone: C/ vs-7 33 K <br /> Contractor Information: <br /> Contractor: Contact Person: <br /> Address: State License#: <br /> City: Zip: Expiration Date: <br /> Phone: Alternate Phone: <br />