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Aor-SO-2�0' 11:2b.m frcm-CITY CF ORqNG +9�224d4616 T-534 P OG1/003 F-105 <br /> 1 ._ � <br /> f i <br /> 4�UR C�"�'Y USC qN�.Y � <br /> '/��A.-�.�>. Ci[y Uf OronO Pzrmitn <br /> yoYo'•O\ ['.0 aox6Cs Da'Cl'.CCCivCd: .� �,__ <br /> 2750 KeUey I'arkwuy �� <br /> � ,�'j,�,,.� _ ,, q�pro4cd By:(It Requi�rdj � <br /> i ��e; xj Crystui Day.MN j5723 �_� <br /> ���eeiwa�4 1l 1q32)2d91i60J ----- — <br /> �,.-....� <br /> CIT`Y OF t��ON4—V�'.�TE1��TER FORM <br /> (•No'e Sorrr:pcirt�iis muy requi:e a�ioti'�!by�he Du,lq;ng Offlcial undior Public WnTk►D��artmaid•) <br /> c�E�r�.. n�o�A�riv�r; T ��_ � <br /> :. W AT�R h�E1'L�tS must hc pi:!ced�p and paid t'or at City T�iali. <br /> z �;�ossib,?r,fax in rhis applicatic�a alzead of ume;we will then call you and let you lmow we have <br /> d�e waier mete.-z iu stock. Fa;:Number:(9�2}249•4G1G. Al�o,you can call xhead ef timr tc make <br /> suce we re�aived tl�e f�x,c�r w warn us that ilie fax is co:ning. <br /> 3, �VA'fEFt NI�T�ltS must 6e set and sealed b�� Oronu Water De(iartment (952} Z49-46U0, <br /> upon conipletion of n�etcr instaAation. <br /> ( T��or��z�� <br /> I��—� (Checic All Tnat A.� l �)� ---- � <br /> ��__-- -- <br /> ��Residcntial(1`Aay Rcq�tire Appravsl) ❑Comu�rciai(Approval Reyui.red) <br /> j Nc.N;"1:ter (�Additiunal?�lcter-For: �_ ❑Replacem�nt Mefer <br /> I 7ob Site/Own�r lnfam�atio.n: <br /> '� � � � �:� <br /> ��t- �v� � r ���� ��� ���z c <br /> S�te A.ildress: _ —�� , <br /> a` � f, , ,— J e Ctl�'C��C+���` �t. I�-�G��, <br /> Owner:�,'�.�1, �r�t.v�. � /7i.�1.t=-� Ma.���� .gdd��ss� ��yyc P t . <br /> �i 1� 1 v'`�-a�` ____ Li.p: �� S �3 C� �Y <br /> City: . . ------- <br /> �� �'/�=�'� A1t�nlate Phone: <br /> Home Pt�onc-: 1���=�_� —_ ---• <br /> Contractor Infar�z�ativn: � ---� <br /> � <br /> _�_ � <br /> Contra.ctor� /_�� l � �_.��CL'��� Contact Person: � �-� -- <br /> , <br /> , �,��-l� J�� --'� �/�,' ��-. <br /> Address: � ���'_��1� �' Sr�te License#: <�=_L��,– <br /> � �� � / � �1 � �-'� � <br /> City: ��V'�-�-� Zit�:_5-���xpic•ation Date: _ <br /> Phane: ���� "�_�� -'I�l`�S� Alternate Phonc: '���� ��lL� ' ��'�_��_ <br /> �_ ��� � �� � � <br /> ,���1�r� � � � <br />