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FOR CTl'Y USE ONLY <br /> ,�O . `O City of Orono <br /> 1V P.O.Box 66 Date Received: Permit# <br /> 2750 Kelley Parkway <br /> Crystal Bay,MN 55323 Appraved Sy:(If Required); <br /> (952)249-4600 <br /> �F��kE o��'G� CITY OF ORONO-WATER METER FORM <br /> S H (1Vote:Some permrts 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 nossible, 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)249-46]6. 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 /> Che�k All That A 1 <br /> [�] Residential(May Require Approval) ❑Commercial(Approval Required) <br /> [`Q New Meter ❑Additional Meter—For: ❑ Replacement Meter <br /> Job Site/Owner Information: <br /> Site Address: �1 ��G C��v� ,��.,�;:.,�- <br /> Owner: �k�� Mailing Address: ��"�� C����-� �-�-- �.��- <br /> City: c7�z�:��� Zip. ����-�, 3 <br /> Home Phone: Alternate Phone: <br /> Contractor Informatian: <br /> Contractor: f�1`=�; �� -�`� ^` �1�- Contact Person: ��'^� -�'�'`�"�� <br /> Address: f l��� �7��� �a�� �-� State License #: �������������-� <br /> City: �+'a� Zip:����'� Expiration Date: j Z� 3 i-��.- <br /> Phone: (���Z- Z�C��� `�°�'' Alternate Phone: <br />