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, . z�o.� <br /> FOR CITY USE ONLY <br /> City of Orono <br /> �-O�O 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 /> a � <br /> y � <br /> F � <br /> �qkESNo��G CITY OF ORONO—WATER METER FORM <br /> (*Note:Some permits may require approval by the Building Official and/or Public Works Department <br /> *� <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 wili 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 ply) <br /> �] Residential (May Require Approval) ❑ Commercial(Approval Required) <br /> �{New Meter ❑ Additional Meter—For: �Replacement Meter <br /> Job Site / Owner Information: <br /> � � / <br /> Site Address: � �b � ��, (� �G''�/I`t" ��� <br /> � � � G � r <br /> Owner: %!/1l Mailing Address: � I�b � ��'����`'�'��� �� <br /> city: �>��`C�C� zi `5�� � <br /> P� <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> Contractor: l(�fS >G'GY'�c�Contact Person: ��� '.SSC� <br /> Address: �14��0 Iy���'�`e State License #: /`����'Z� �2 <br /> City: � � � � Zip:-S��d � Expiration Date: /2 �� ��� <br /> Phone: �7�P��(�j'���� Alternate Phone: ��'3 ��� ��'"�����5 <br />