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Mar 30 16 11:19a Lake Country Plumbing, I 9524675000 p.1 <br /> � <br /> � <br /> FO CiTY USE O'_VLY <br /> �O A T Cit}'of Orono ��j �/`���— O��7 <br /> 1 yO P.O.Box 66 Daie Receick�' it� '�l� <br /> 2?50 Kelley Padc�vay <br /> tCrystaf Bay,MN 55323 Approved By:(If Required): <br /> ` � (952)�49�600 <br /> 1 y� � <br /> � ti�' CITY OF ORONO—WATER METER FORM <br /> ��ES 4i�Q' (note:Some permils may requim approval'oy the Building Official andlorPublic Wo:ks Departmcnc) <br /> ' GENERAL INFORMATIO�I <br /> 1. WATER METERS must be picked up and paid for at City Hali. <br /> 2. Tf vossib{e,fax in this application ahead of time;r��e will then call you and]et you know we have <br /> the water me4er in stock. Fax Number:(952)244-4616. Also,you can call abead of time to make <br /> sure we received the fax,or to v��arn us thac ti�e fax is coming. <br /> 3. WATF.R �iETERS rnnst be set and sealed by Orono �Vater Department (952) Z49-�600, <br /> upon completion of ineter installation. <br /> TYPE OF PERMIT <br /> (Check.All That A i <br /> ❑Residential(May Require Approval) 0 Commercial(.Approval Required) <br /> �New Meter ❑ Additional Meter—For; ❑Replaccment Meter <br /> Job Site/Owner Information: <br /> Site Address: �-��7 �r}-S�_E. C'I('C[ � _ <br /> O��ner: s T"'''� �� Mailing Address: ��,'�t�� <br /> Citv: Z1P= <br /> Home Phone: Alternate Phone: <br /> ' Contxactor Information: <br /> � <br /> �, j,�'� <br /> „. <br /> Contractor: �:� ��''�':ti��'"7 �"',�^"`� ContactPerson: � �� � ��!������'Y`�`''� <br /> Address: i��' �'�� ?�` State License+: ��G `.%�`% �y <br /> t r ,..- �---�:� <br /> City: �,i'�,��-+.��ti' ''� Zip: �J-'�'' Expiration Date: i� '� i ; <br /> Phone: .�i�r.�- -�`1 � J'.�� Alternate Phone: �,15�- '-r�v I ���'c r <br />