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� . <br /> FOR CITY USE ONLY <br /> ��� City of Orono <br /> P.O.Bor 66 Date Received: Permit# <br /> � 2750 Kelley Parkway <br /> Crystal Bay,MN 55323 Approved By:(If Required): <br /> (9�2)249-4600 <br /> � � <br /> S � <br /> F � <br /> � ��,�' CITY OF ORONO—WATER METER FORM <br /> �kESH� (*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 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 pl ) <br /> d Residential (May Require Approval) ❑ Commercial(Approval Required) <br /> ��New Meter ❑ Additional Meter—For: ❑ Replacement Meter <br /> , <br /> Job Site/ Owner Information: <br /> Site Address: U o l� rPG' � f�-��jP ,9� 5 S <br /> Owner:�U✓Vle��'Y!� V iCYP� Mailing Address: <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> /", � <br /> i l_ <br /> Contractor: � I er U�vl V1�J Contact Person: <br /> / <br /> Address: � ��� S� n��G �Pe Ln State License #: <br /> City: �CVI l"c1��L Zip:SS Expiration Date: <br /> Phone: �;."�L c���L S 7 y� Alternate Phone: �5 Z 2�? Z ZS3 <br />