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. w� <br /> � � . <br /> C[ Y USE ONLY <br /> �%��', City of Orono � /� <br /> � <br /> �� ¢ �� P.O.Box 66 Date Receiv :� Permit# D 6 <br /> i/ _ '� ��' 2750 Kelley Parkway <br /> �,Iv,.,...,. <br /> � �j'�'x,` �.1, Crystal Bay,MN 55323 Approved By:(If Required): <br /> ��� �i�'�%�:ryo`/ (952)249-4600 <br /> \iskaexo�i/ <br /> �-_,_� <br /> CITY OF ORONO—WATER METER FORM <br /> (*Note:Some permits may require approval by the Building Ofticial 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 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 1 <br /> [�Residential (May Require Approval) ❑ Commercial (Approval Required) <br /> �New Meter � Additional Meter—For: � Replacement Meter <br /> Job Site /Owner Information: <br /> Site Address: i l `� (� ��� �� �,���,� �°`�'� <br /> Owner: L �`'r`�� �u��� Mailing Address: <br /> ,r'' n L <br /> City: J Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> Contractor: ���'W,.r fi �`ir�.1�;, �,r(., �er•� ��--I�.L d� <br /> � � Contact Person: <br /> Address: 1���� ���' ''��- ��'� �� State License #: <br /> �� �t � I <br /> City: c �� Zip:�9�31 y Expiration Date: <br /> Phone: ?6-�- ��' ��� �7 Alternate Phone: <br />