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Sep�.O 2010 7: 56RM STEWRRT PLUMBING 7634281733 p. l <br /> � <br /> , + �\ <br /> FOR CITY US�ONLY <br /> �p� City of Orono <br /> o :. o P O.Bmc 66 Dateltecei��ad 9�,��►,�� aOio -o �z3 <br /> �; 2750 Kelley Parkway <br /> > Crystal Bay,MN 55323 <br /> L; �� (452)Z49-4600 ApP�O�'�By:(If Aequired): <br /> ��O <br /> CITY OF ORO O—WATER METER FORM <br /> ("Note:Some pennits may rcquire appr val by thc 8uilding Official and/or Public Works Department�) <br /> GENERAL INFORMATION <br /> (. WATER METERS must be picke up and paid for at City Ha1l. <br /> 2. If ossi e fax in this application ead of time;we will then call you and let you know wa have <br /> the water met�in stock. F�Num r:{952)249-4616. Also,you can caJl ahead of time to make <br /> sure we received the fa�c,or to w us that the fa�c is coming. <br /> 3. WATER METE85 must 6e aet and sealed by Orono Water Department (952) 249-4600, <br /> npon completion of ineter insta] tion. <br /> - T E 4F PBR1VfIT <br /> C}� ck.All�'hat A I <br /> ❑Residendal(May Require Approval) []Commercial(Approval Required) <br /> �New Meter []Additional M ter—For: <br /> ❑Replacement Meter <br /> Job Site /Owner Tnformation: <br /> Site Address: ���5 WY1(�,fl�' rj�' p�,-�'Q <br /> Owner: Mailing Address: <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor Infartnation: <br /> C ontractor: � P��► �,. Conta.ct Person; Qy�� ( <br /> Address: 13t�2.� l�e�r�,� �r pr State License#: �1�� ip m <br /> City: � Zip. 3�} Expiration Date: _ 1��31��p <br /> Phone: �l(a3-�}Z�- 1�33 Alternate Phone: �pla-3�(�- (��q I <br /> I <br />