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Feb 03 2015 02:12PM HP FaxScherer Plumbing 9524476735 page 4 <br /> a • � <br /> . <br /> . <br /> City of Orono FOB CTTY USl'i ONLY <br /> ���� � . <br /> P.O.$ox 66 I]af,�Received: � pq��t�#�'i15- <br /> 2750 Kclley Patkway ��� <br /> Ctystal Bay,MN 55323 Appic�ved By�(If&equired): <br /> � (952)24y-460Q <br /> � ti : <br /> er' G� <br /> r��ESN¢�:� CITY OF'ORONO—WATER METER FDI��I <br /> ('Note:Some permitF inay require approval by the Building Oftic�al and/or Public Vb'otics Deparhnent <br /> �� <br /> �E7'�TERAI,INFORNiATION <br /> 1. WATER METERS must be picked up and paid for at City Hall. <br /> 2. If possible,fas in this application ahead of time;we will then call ydu and Iet you know we have <br /> the water meter in stock. Faac Nun�ber:(952)249-4616. Also,you can calt ahead of time to make <br /> sure we received the faz,or to wam us that the fa�c is coming. <br /> 3. WATER METERS must be set and sealed by Orono Water Departn�ent (952) 249-4600, <br /> upon completion of ineter installation. <br /> TYP�OF PER1vIIT <br /> Chec1�Al2 That t1 1 <br /> ✓�Residentlal(May Require Approval) ❑Commercial{Approval Required} <br /> [�New Meter ❑Additional Meier—For: <br /> ❑Replacement Meter <br /> Job$ite/Owner Infartnation: <br /> , ` <br /> Site Address: ���� ��1 P 1 Q.Cc�„ <br /> .�Q`� ��- Owner: �`��� l..L� <br /> � Mailing Address: <br /> City: Zip: <br /> Home Phone: Alternate Phane: <br /> Contractor Information: <br /> Contractor: �UI UWP�'� �,�`j���(�on��Person: ��--� ���C.VPy <br /> Address: ��Sy�° �� �S�S�'State License#: �J�Z�2. <br /> City: Q1'��6� �.� Zi 1 Z. <br /> p:�i'�1�i�L Expiration Date: ` ���1� <br /> Phone: ��7�.-�IU� -�o��jy Altemate Phone: �( �- ��� - ��`6 � <br />