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FOR CITY USE ONLY <br /> City of Orono <br /> �-�NO 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 /> � � <br /> S ` <br /> F <br /> t�kESHo��� CITY OF ORONO—WATER METER FORM <br /> (*Note:Some permrts 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 qossible,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 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 /> Site Address: C.-. � � � CSa �/ �o t.� 1 � • <br /> Owner: v�Tfi' �G� �� �.,. Mailing Address: <br /> City: D,r�/1O Zip: <br /> Home Phone: lS Z � y ��(D Alternate Phone: <br /> Contractor Information: <br /> Contractor: 11�(\ �-^^ �'<<rl Contact Person: , l (� <br /> Address: ! State License #: <br /> City: �P�i� Zip:� Expiration Date: <br /> Phone: �SZ��I -! 7�_ Alternate Phone: <br />