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� <br /> � FOR CIT USE ONLY <br /> ,�0\ City of Orono <br /> P.O.Box 66 Date Received� Permit# <br /> �" � 2750 Kelle Parkwa <br /> s�t Y Y <br /> a �'`� ''' C stal Ba MN 55323 A roved[3 [f Re uired : <br /> ,� �ll ��r�c�- �,' rY Y, PP Y�� 9 ) <br /> a����r��.�o (952)249-4600 <br /> agao8 <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. I�ossible,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 Apply) <br /> � Residential(May Require Approval) ❑ Commercial(Approval Required) <br /> ❑ New Meter ❑ Additional Meter—For: �Replacement Meter <br /> Job Site/ Owner Information: <br /> Site Address: 3 3�� �' ,��.,,.,� ��(. <br /> ; <br /> Owner: �J�r1 �'-P'�=-�n Mailing Address: 33� L'1�`� � ,�.�- <br /> �— <br /> City: �(R?7�-f? Zip: ��' ( <br /> Home Phone: C�S�, �{"1 f - �(�� Alternate Phone: � <br /> Contractor Information: <br /> Contractor: Contact Person: <br /> Address: State License #: <br /> City: Zip: Expiration Date: <br /> Phone: Alternate Phone: <br />