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FOR CITY USE ONLY <br /> ,�` City of Orono <br /> 4O`V P.O.Box 66 Date Received: Permit# _ <br /> ��,�,,� � 2750 Kelley Parkway <br /> ' �Il�'�"`� �' Crystal Bay,MN�5323 Approved By:(If Required): <br /> � ��'��r�$�o` (952)249-4600 <br /> �FBX� <br /> CITY OF ORONO —WATER M�TER FORM <br /> (*hote:Some permits may require approval by the Buildino 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 Uossible, 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: (9�2) 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 conung. <br /> 3. WATER NTETERS must be set and sealed by Orono Water Depa��tment (952) 249-4600, <br /> upon completion of ineter installation. <br /> TYPE UF PERMIT <br /> (Check All That Apply) <br /> Residential(May Require Approval) ❑ Commercial(Approval Required) <br /> �ew Meter ❑ Additional Meter—For: [�Replacement Meter <br /> Job Site/ Owner Information: <br /> ( � � � � � <br /> Site Address: `J � � — Q � <br /> ' 1 <br /> Owner: �t��f ��'�� Mailing Address: � �Q��� �L"'�- <br /> ��City: Zip: �� � <br /> <' �j <br /> Home Phone: ���� �' ��� Altenlate Phone: �/� ����`��� <br /> Contractor Information: <br /> c._ �.� � �� �C r C��,,� <br /> Contractor: ��� Contact Person: <br /> Address: State License #: <br /> City: Zip: Expiration Date: <br /> Phone: Alternate Phone: <br />