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; ' ► <br /> ' FO ITY USE ONLY <br /> 0,�` City of Orono 0�8'�/ <br /> O4 `rO P.O.Bax 66 Date Received: ermit# D ��� <br /> �,�,r„2 2750 Kelley Parkway <br /> �d�����ri�o�G�F (952)2 4a46 ON 55323 ApProved By:Qf Required): <br /> aexo$ <br /> CITY OF ORONO-WATER METER FORM <br /> (*Note:Somc 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 applicarion 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 Apply) <br /> �esidential(May Require Approval) ❑ Commercial(Approval Required) <br /> ❑ New Meter ❑Additional Meter—For: ❑ Replacement Meter <br /> Job Site/ Owner Information: �� <br /> Site Address: 02.`�`11 Co�m�v� <br /> Owner�oes ��L.v'S'tl Mailing Address: <br /> City: blz�o zip: <br /> Home Phone: 5� • 381� 0�17p Alternate Phone: <br /> Contractor Information: <br /> Contractor: � S �� �►1� Contact Person: �G 'h��X+-���S T- <br /> Address: �O�j �.,���Srw, -�e.� State License #: D 5958v <br /> City: f�'1'CY� Zip�S Expiration Date: �L �'�1 � � C� <br /> Phone: ciK� �3 3• Z 8 3 C Alternate Phone: <br />