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WATER METER PERMIT FEES <br /> WILL BE CAULULATED BY CITY STAFF <br /> ❑ 5/8"METER- 4"METER- � 1"METER- <br /> � 5/8"HORN - "HORN - � 1"HORN - <br /> � �"WATER METER (THESE WILL HAVE TO BE SPECIAL ORDERED&PRICES DETERtiI1NED) <br /> 1. METER FEE: $ <br /> 2. HORN FEE $ <br /> 3. TOTAL PERMIT FEE(Add Lines 1-2 Above) $ <br /> CITY-USE ONLY <br /> * For Current Pricing Refer to Current Year- Water Meter Pricing Chart * <br /> BRAND: <br /> SIZE: ❑ 5/8" 3/4" ❑ 1" ❑Other " <br /> SERIAL#: � ��� c"j ��3 <br /> ERT HIGH#: IIl�II���I��������������l��l� (if applicable) <br /> 1831713052 <br /> ADDITIONAL 1NFORMATION—WATER METERS <br /> The undersigned hereby applies to the City of Orono for issuance of a water meter perinit, agrees <br /> to do all work in strict accordance with the ordinances of the City and the regulations of the State <br /> of Minnesota, and certifies that all statements made on this application are,true and correct. <br /> � <br /> �' <br /> �,: <br /> / ,�y � <br /> ApplicantL.,-�� Q �� Date: N� �� <br /> Reset Form ;; <br /> �;� <br /> O�•iginal: I-Address File <br /> Make Copies For: 1- Utiliry Billing Department 1- Cash Drawer <br />