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, <br /> , , ', i �i.V�S <br /> � ,� �� . <br /> t FOR CITY USE O1VLY �,� <br /> ' �"�-"�� City of Orono �<�- �( (� <br /> � �� �� P.O.Box 66 DaCe Received: �( ��� `�Permit# ��W � <br /> � fl�,�,, , �� 2750 Kelley Parkway <br /> "� �ly�`� h' Crystal Bay,MN 55323 Approved I3y:(If Required): <br /> C._ <br /> \,� � ��yaf/ (952)249-4600 <br /> 1�"�o . <br /> CITY OF ORONO—WATER METER FORM <br /> (*Note:Some permits may require approval by the Building Official and/or Publie Works Department*) <br /> GENERAL INFORMATION <br /> 1. WATER METERS must be picked up and paid for at City Hall. <br /> 2. If�ossible,fax in this application ahead of time;we will then call you and let you know 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 A 1 <br /> �Residential (May Require Approval) ❑ Commercia] (Approval Required) <br /> �New Meter �Additional Meter—For: �Replacement Meter <br /> Job Site/Owner Information: <br /> Site Address: �' � ✓ .�._,� <br /> Owner: ��- � Mailing Address: <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> � � �� <br /> Contractor: Contact Person: <br /> Address: lvZ��' '' � -..vU�State License #: ���/,j���� <br /> . - � <br /> City: ��� � 'Zip: � S��'Expiration Date: ��' 3�D� <br /> � <br /> i.. <br /> Phone: ��'�)�/ 3� _/`�� Alternate Phone: <br />