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FOR CITY USE ONLY <br /> ���` City of Orono �/ <br /> 4 �`Y P.O.Box 66 Date(teceived: ����-1�1'�ermit# <br /> ��;,, � 2750 Kelley Parkway <br /> � i�j1?�Ej'. � Crystal[3ay,MN 55323 Approved By:Qf Required): <br /> �' ��r4,4�`}'6G` (952)249-4600 <br /> ��axo$ <br /> CITY OF ORONO —WATER METER FORM <br /> (*Note:Some permits may require approval by the Building Ofticiai 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 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 wain us that the fax is coming. <br /> 3. `'VATER 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 /> �.Residential(May Require Approval) ❑ Commercial(Approval Required) <br /> �New Meter ❑ Additional Meter—For: ❑Replacement Meter <br /> —1 �'2 i l_> `-.. � I k_) <br /> Job Site/ Owner Infornlation•, ���-> �`� z <br /> ;G�� .r/ _ � .� - � <br /> Site Address: `� �� ��G v�- � <br /> � ,-� � � ,c �� �=1�(c(� P� S <br /> Owner: 5�tan.2l��d� f``�< / ��` t Mailing Address: <br /> J <br /> City: S�r�� �1`� Z�ip: <br /> Home Phone: Alternate Phone: <br /> �f� �- ��7/ ' �� 5�� � <br /> Contractor Information: <br /> Contractor: ST�,l,�li}•r+ Q���D�� Contact Person: �/ Z - .��� - <33� �- ���- <br /> Address: ��S ���' �� State Lice�nse #: �(�SL?c��: ��� <br /> City: �� S Zip:55_3�`� Expiration Date: �� ' � j � �'� <br /> Phone: ���`��2`�-/g-S � Alternate Phone: <br />