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r <br /> FOR C1TY USE ONLY <br /> �Q� City Of�COI10 3�� <br /> P.O.Box 66 Date Receivedf/ Permit#�l� � d I�� <br /> ��;;,,,,, � 2750 Kelley Parkway <br /> a t�''�;<<: � Crystal Bay,MN 55323 Approved By:(If Required): <br /> � ��,G <br /> �^����r$�o` (952)249-4600 � � <br /> ��exo <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 lcnow 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 ineter 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 /> Site Address: i'y3 ,��,�./,�.z-�N <br /> � <br /> Owner: � � Mailing Address: <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> Contractar Information: <br /> Contractor: ,f' Contact Person: �� � <br /> Address: /���-���„����/ State License#: d.S��7,j y ��� <br /> City: (�� � �, Zip:S��� � �Expiration Date: �� 3� �b <br /> Phone: ��,5��/.s,3�'Gy Alternate Phone: <br />