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FaR crrr uss arR,x <br /> OCity of Or000 <br /> /� P,U.13ax 66 Dute Receivnd; PcmRit k <br /> � V 2750 Kelley Padcway <br /> Crye�W Bey,MN 55323 Ag�roved Ay,(If Raquuod); <br /> (932)249-46q0 <br /> % �' <br /> � <br /> �� CITY QF ORONO�-WA.TER M�TER FORM <br /> �'�kf S H�Q'� �.Np� �me pctmitn muy tcyuire epprovel by the Ruilding Off'icisl und/ut Publie Wodcs DeparCnant <br /> e� <br /> GEN�RAL INFORMATION <br /> 1, WAT��t METERS must be picked up arnd paid for at Ciry Hall. <br /> 2. Tf uossib�e,fax in this application ahead of timc;we will then call you and let you know we have <br /> the wAter mener in steek. Fax Number: (952)Z49-4616. Also,you can call pheAd of time to make <br /> sure we received the fax,or to wam us th�t the fax ig caming. <br /> 3. WATER ME'�ERS must be eet and sealed by Orono Water Department (952} 249-4600, <br /> upon completion o(metcr installation. <br /> TYP�Q�'�1tNllT <br /> Check All That A 1 <br /> �Residential(May lZequire Approval) ❑Commercial(Approval Required) <br /> �New Metqr ❑Additional Meter—For� ❑Replacomant Meter <br /> Job Site/Ow�er In�orma#ion: <br /> Site Address: ��"�� e-���"'`� `-"' ` � <br /> Owner; Mailing Address' <br /> City: - - Zip: <br /> Horne Phone: Alternate Phone: <br /> Contractor Informatiora: <br /> Contractor: � � �UIVI��/y Contact Person: �t(��l� �7'u.�41�'1 <br /> Addr�ss: ����� ���i U�'� a` state i.icense#: �� � � 3 B �� <br /> City� � t�� Z�p����1� Expiration Date: �a � <br /> Phone: ���1 " �I� "7 y y 3 Alternate Phone: - ^ <br /> si <br /> Z �d 9T9�6�ZZ�6 <— ��I'I �u�qmntd �uz.zdS ZQ� W�'L� �60 �T/ZZ/60 <br />