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FOR CITY USE ONLY <br /> ,� �� ',�` Citv of Orono <br /> �� //� �O`Y\°' P.O.Box G6 Date Received: Permit# <br /> '`'�� � `�I 2750 Kelley Parkway <br /> ��a )t`' �����_ ! Crystal Bay,MN 553'_3 Approved By:(If Required): <br /> �'; <br /> d� ���, �,},u`� (952)249-4600 <br /> ,�vr�o8�,/ <br /> CITY OF ORONO–VVATER METER FORM <br /> (*Note:Some pennits may require approval by the Building Official ancl/or Public Works Department*) <br /> GENERAL 1NFORMATION <br /> 1. WATER METERS must be picked up and paid for at City Hall. <br /> 2. If�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 A 1 <br /> ��Residential (May Require Approval) ❑Commercial (Approval Required) <br /> i <br /> � Ne���Meter � Additional Meter—For. � Replacement Meter <br /> Job Site/Owner Information: <br /> / � ,r <br /> Site Address: �T��7 > CG� 4:� � 1���— -�?l — <br /> Owner:���) �_ ��Lt'L�. � ��'����A�Iailing Address: %L � � � �1/�C, � L�; <br /> � <br /> ����� <br /> City: ������ I���' Zip: _��/ �� <br /> ,�� �� 1 � �.�� �� % �'7Z� <br /> Home Phone: i� !L%"� C j��' Alternate Phone: <br /> Contractor Information: <br /> _ j <br /> Contractor: ^�"f�� �� Contact Person: �,t jT'� , <br /> i-'_ <br /> � 7 , , <br /> Addres���y� � - � �f� >� State License #,: <br /> ' i�_.- <br /> City: ��l`,'�� Zi�.f�.�Expiration Date: <br /> ' '_ �'� �� L" �� <br /> Phone:��� �"� ��� �� ; Alternate Phone: ��� F.x-� � <br />