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FOR CITY USE ONLY <br /> City of Orono <br /> P.O.Box 66 Date Received/Qya/4 Permit# <br /> 'R 2750 Kelley Parkway <br /> R-,, <br /> Crystal Bay,MN 55323 Approved By:(If Required): <br /> (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 /> pRf/ N <br /> New Meter ❑Additional Meter—For: El Replacement Meter <br /> Job Site/Owner Information:' <br /> Site Address: 02l S _J" <br /> Owner: Mailing Address: <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> Contractor: O �� ontact Person: — <br /> Address: /P-2 7a LO, State License#: 2f <br /> City: Zip:.3S3 �,Expiration Date: <br /> Phone: 3 --li/oe Alternate Phone: <br />