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_ . . <br /> F R CI Y USE ONLY <br /> �'�j�'�� City of Orono n <br /> ,� ��—��� <br /> f � � �'�� P.O.Box 66 Date Receiv .� �ermit# (/ <br /> �i �� , �1' 2750 Ikelley Parkway, <br /> t�� �11y�` '- ���;� Crystal Bay,MN 5�333 Approved By:(]f Required): <br /> \a �'' � .,z.o�if (952)249-4600 <br /> �EeH�p�; <br /> ___"':.., <br /> CITY OF ORONO—VVATER METER FORM <br /> (*Note:Some permits may�rcquire approval by the Building Official 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 cal]you and let you know we have <br /> the water meter in stock. Fax Number: (952)249-4616. Also,you can cal] ahead of time to make <br /> sure we received the fax,or to wam 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) ❑ Commercial (Approval Required) <br /> � New Meter �Additiona] Meter—For: � Replacement Meter <br /> Job Site/Owner Information: <br /> Site Address: �� � �� ��L <br /> Owner: Mailing Address: <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> � S�/uf/a ys /�j �Q � � <br /> Contractor: ��� S�llif/�j%/✓J° Contact Person: / ��� //-� �� <br /> Address: �S�j ��y�h�de Nl,� State License #: � � � �� <br /> City: �1�� Zip:SS-3��Expiration Date: I oZ — p�0 ! � <br /> Phone: �,)�—J �� �g��-J Alternate Phone: �j ��� ��� S g� <br /> � � <br />