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FOR CITY USE ONLY <br /> �O ,� `O City of Orono <br /> 1� P.O.Box 66 Date Received: Permit# <br /> 2750 Kelley Parkway <br /> Crystal Bay,MN 55323 Approved By:(If Required): <br /> (952)249-4600 <br /> � � <br /> yF � <br /> ��kssr-io��"G CITY OF ORONO—WATER METER FORM <br /> (*Note:Some permits may require approval by the Building Official and/or Public Works Department <br /> a� <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: eplacement Meter <br /> Job Site / Owner Information: <br /> � , �� � � <br /> Site Address: ��� �`,— �(�� (� � � 1 � �'�� <br /> �, <br /> Owner: ��fr �' ,�`Jv��� ;�j(�j�f Mailing Address: , (S �' <br /> City: l i�('d' ���', Zip: -� ��� �— �� �� <br /> Home Phone: ��—�� � ����J�; Alternate Phone: �'� � � —� ���� . <br /> Contractor Information: <br /> Contractor: Contact Person: <br /> Address: State License #: <br /> City: Zip: Expiration Date: <br /> Phone: Alternate Phone: <br />