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12/17/2015 09:57 7632592299 SCHULTIES PLUMBING PAGE 62/07
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<br /> ���� City of Oron� �, y , '
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<br /> ���'�� sHo�a��� CITY QF OR�NO--WATER]►�ETER FORM
<br /> (1Vote;Somc permj(g may requiTc aPprovaf hy the Building Qfficial nnd/or Public Wprks Dcpartment)
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<br /> 1. WAT'�R ME'['�RS musc be picke(1 up and pRid for at City HRII.
<br /> 2. I�q�s�'b1e,fa�c in this application ahcad of fimc;we will the�cal]you�utd let you know wve havC
<br /> the w�er metcr in stoCk. F'ax Numbe�: (952)249-4616. Also,ydu can Call ahead of time to make
<br /> sure we receiv¢d the fax,or to warr,us that the�Ax is coming.
<br /> 3. WATER M�TERS �nus� be set �nd sealed by brono Water DcpArtme�t (952) 249-4600,
<br /> upon eompletion of ineter iastallatxon.
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<br /> (�Residentisl(May Require Appro�ttl) ❑Commcrciai(Approval Rcqaired)
<br /> ,�,.New Metcr ❑Additiona!Meter—For� ❑Replaccment Metcr
<br /> '�'��'a��t�t�C�r�'t�ri Z���+r'm�Ct�.
<br /> Site A,ddress: "
<br /> Owrler Mailing fl,ddress: �/ ��������
<br /> City:
<br /> Zip:
<br /> Home Phone: �`�. Allernate Phone: '"-- �
<br /> '�`u�h�i�t�il',,Tr�'�rt`�ti��t�i`i�r ` , ,
<br /> Contractor: ' COt]tact PEtSon: �
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<br /> Address: State License#: /��,�:
<br /> C��3'= ` Zi}�� Expiration Datc: � o�-�`
<br /> Phone: 7�3���� Alternate Phone: �$
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