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09/05 2007 12:37 FAX 76� 591 6071 IVERSON 1�001 <br /> I � � <br /> � FOR Cl'CY.USE ONLY:.;' . , <br /> Ci of Orono ``;` ` � �' � <br /> o �' ,pataReceived:' . .Perm��#��=,. <br /> I O�' �� P.O.Box6G , .••". �� � ,. <br /> 2750 Kelley Parkway �. , ' ' <br /> �'� rt Crys�l Day,MN 553z3 Approvcd By:(If Required); . :i> �.; � <br /> �t,'����d°'� (9S2)249�G00 , .. ' . ' <br /> � CIT'Y OF ORONO --'WATE�t 1VI�TER FORM <br /> (*Noce;Some parmits may requiT�aPProval by che 8uilding OfFicial ond/or Public Works Deparlment") <br /> j ,. <br /> CrENERAL�TNFORIVIAT.ION : . <br /> I , t. WA,TER METERS must be picked up and paid for at City Hall. <br /> 2, If pp$$ible,fax i,n tlus application ahead of tix��e;we will t11en.cal]you and let you l�ow we k�ave <br /> tl�e watrr�eter ui stock. Fax Nuruber: (952)249-4616. A�so,you can call ahead of tinie to ir,ake <br /> staxe we received tl�e fax,or to waxu us that the fax is coming. <br /> 3_ WAT�R METERS must be set and seAlcd by Orono VVater Departmc�nt (952) 249-4600, <br /> upan coropletion of ineter installation. <br /> , , , <br /> �'YPE�OF PERM.�T ' � <br /> Che.cic��All That A. 1 <br /> ❑ Residcntial(May Require Approval) ❑ Commercial(Approval Required) <br /> New Iv�eter ❑Additianal Metez—ror: _ ❑Re�lacement Mcter <br /> � <br /> Job Site/Owcler.Yn£orniatioa�: ' <br /> ' <br /> , Site Address: ( a � �`� <br /> Owner: �u��haA ����� Mailing Address: <br /> City: ZiP� <br /> �Iome Phone: Altez7�ate Pl�o��e: <br /> Con1'ractor Information: <br /> ��� � <br /> Contractor: n l� �`j Con.tact pezson: <br /> I <br /> Address: � 4 � s �� State Licez�se#: <br /> City � � Zip�+� Expiratioz�Date; <br /> � <br /> phor_e: � Altexnate Pl�o�le: I�j� 3 63�3 2��p <br />