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v--,---t.._A 5(t2(,-7 <br /> • <br /> FOR CITY USE ONLY <br /> O�T City of Orono � / Z -�� ✓ <br /> WP.O.Box 66 Date Received: J/l`1 1P mit# yg! <br /> 2750 Kelley Parkway <br /> Crystal Bay,MN 55323 Approved By:(If Required): <br /> (92)249-4600 <br /> o4Z CITY OF ORONO—WATER METER FORM <br /> S H (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) ❑ Comrngfcial(Approval Required) <br /> D New Meter ❑Additional Meter—For: Replacement Me. ,4,.,ter <br /> Job Site/Owner Information: ia7, <br /> ez0„, <br /> Site Address: g.350 SaG aGIS �g,,,,id,in <br /> Owner:1272Z�1PiVai, p fling Address: Z ;n <br /> City: ff Zi R1 <br /> "e5 �!/��I i 1144--64.1 I ,0 <br /> p• <br /> 7 Home Phone: q9--).- 34-- (15TAlternate Phone: m,? J <br /> Contractor Information: <br /> Contractor: C! UI ec.J 0) 1i5 ntact er n: Ott.,/ "/� , W� <br /> Address: !1-' tate License #: +5 J p 7 6 3 <br /> City: Lerr Cake Zip: Expiration Date: <br /> SriG <br /> Phone: Alternate Phone: <br /> 9$ - q73--??3 <br />