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12/17/2015 09:57 7632592299 SCHULTIES PLUMBING PAGE 03/67 <br /> �. <br /> 5/8"MET$�t- ❑ 3/4"MF'TER- ❑ 1"METF,R- <br /> 5/S"HORN - ❑ 3/4"HORN � <br /> Q l"F�IdRN - <br /> lJ �'�'WATER MET�R ('TITI;SE WTf,L ii11VF:'�'O B�i$p�t,'Ul.p�DER�;A&PRICES DTyT�RMIN�b) <br /> 1. METER FEE: � <br /> 2. HOR'V FE� $ <br /> 3. TOTAL�ERM1T FEE(Add Lines 1�2 Above) � <br /> CI7'Y'-LJSE()I'�L� <br /> * For Current Pricing Refer to Current Year T Water Meter Pricing Chart * <br /> E3RAND� � <br /> 1 <br /> ' S18x3/4 <br /> srzE: �si8�° �3�a�° � �„ ❑oth� „ 3^,06��1727' <br /> s����#: _ II I I I I r��i�ll II I I IIII i�III III Ifl <br /> ����������������������������� —. <br /> ERT HiC,H#: _ 1850421059 (if applicable) <br /> , , , , ;',�,��'�Y�'��4i1»;'��Y�1`�%�i!�'TTT+C��1�`;' ��'�'�,�,`1�,;; ,��,_,',„ ,�,, ��%'.i,, �, ,��;; <br /> The undersigncd hereby applies to tlie City of Orono for rssuance of a water rneter permit,agrees <br /> to do all work in strict accordance with the ardinances of the City and the regulations of the State <br /> of Mintlesota,and certifies that ali statements made on this applicataon are,tnie and correct. <br /> �.pplicant: bate:�r�����/�=��� <br /> Original: I-Address Fi[e <br /> Make Copie.s f+or, 1- (Jlilifiy Billi�g Departrraerrt <br />