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FOR C[TY U5E ONLY <br /> 4�� City of Orono <br /> Y.O.Box 66 Date Received: Vermit# <br /> �;�;,, � 2750 Kelley Parkway <br /> a '`j"�r�'� � Crystal[3ay,MN 55323 Approved By:(If Required): <br /> f <br /> ��+ ���j��i�.�o' (952)249-4600 <br /> �$axo <br /> CITY OF ORONO -WATER METER FORM <br /> (*Note:Some permits may require approval by the Building Ofticial 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 application ahead of time;we will then call you and]et you know we have <br /> the water meter in stock. Fax Numbei: (952) 249-4616. Also,you can call ahead ot'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-d600, <br /> upon completion of ineter installation. <br /> TYPE OF PERMIT <br /> (Check All That Apply) <br /> �Residential(May Require Approval) ❑ Commercial(Approval Required) <br /> 0 New Meter ❑Additional Meter—For: ❑Replacement Meter <br /> Job Site/Owner Inforn�ation: <br /> Site Address: ,.Z,��� Gc�S� �>:.✓} ICc��e� <br /> Owner: �.,n,�S �Ut-f S Mailing Address: <br /> City: C�r�v c� Zip: <br /> �Iome Phone: Alten7ate Phone: <br /> Contractor Information: <br /> Contractor: ���n9 ;�l �/� ;,�, Contact Person: �"i^1 S erv.�� <br /> Address: 71;� 3 S- �Y����f State License#: 6('> �,��wl. <br /> City: Zip:S"�,S��,zS�xpiration Date: /2 '31 -a� <br /> Phone: ,�20--���- �/`It> Alternate Phone: _,,�,�0 �;ya -�66f <br />