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� <br /> WATER METER PERMIT FE�S <br /> WILL BE CAULULATED BY CITY STAFF <br /> ❑ 5/8" METER- 3/4" METER- ❑ 1"METER- <br /> ❑ 5/8"HORN - �] 3/4" HORN - ❑ 1"HORN - <br /> ❑ " WATER METER (THESE WILL HAVE TO BE SPECIAL ORDERED&PRICES DETERMINED) <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#: � � � �' / Lv � 7 <br /> ERT HIGH#: II�III���III�I III II�I I I(I��II �f a licable <br /> — 1831526775 � PP ) <br /> ADDITIONAL 1NFORMATION—WATER METERS <br /> The undersigned hereby applies to the City of Orono for issuance of a water meter permit, 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 /> Applicant: / '�✓�" Date: �� 1'T >Y <br /> Original: I-Address File <br /> Make Copies For: 1- Utiliry Billing Department 1-Cash Drawer <br />