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� � <br /> FQR ITY SE ONLY <br /> �----=_, c s <br /> City of Orono / <br /> I��O��0�� P.O.Box 66 Date Received:� Permit#�'j—�`�`-"� /D/ <br /> ;�,,..,,, 2750 Kelley Parkway <br /> ,I� Jj�'!`r� �I Crystal Bay,MN 55323 Approved By:(If Required): <br /> \ � �yj.�G� �9$�.�249-46�� <br /> \��XO�� <br /> CITY OF ORONO—WATER METER FORM <br /> (*IYote:Some permits may require approval by the Building Official 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 oossible,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 wam us that the fax is coming. <br /> 3. WATER NIETERS 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 /> �ew Meter � Additional Meter—For: � Replacement Meter <br /> Job Site/Owner Information: <br /> Site Address: /�v Cr�K �� ��4. ss <br /> Owner: Mailing Address: <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> Contractor: B��� u'i0��'`� ��'M�� �Contact Person: v �'�� OQ Y"�� <br /> Address: sv��' ��PhO` � State License #: S 77 / <br /> City: � � ^+t-�-�'aN Zip:s�37/ Expiration Date: /o� ' 3�� �l <br /> Phone: ?�3 `3�7` 0��� Alternate Phone: ��' 3' �;g� �� <br />