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r , <br /> � � (�/ FOR CLTY USE ONLY <br /> ,�` City of Orono ` � <br /> '�y�'O`Y p.p.gox G6 �� Date Received: Permit# <br /> �` � 2750 Kellcy Parkway � <br /> �,�� A roved B If Re uired <br /> a �Il�'�,�,r�',- �',' Crystal Bay,MN 55323 PP Y�� 9 )� <br /> �v �;�'�,.,��.'i�o o (952)249-4600 <br /> �lit'.i�>�$6 <br /> saxo <br /> CITY OF ORONO -WATER METER FORM <br /> (*Note:Sume permits may require approval by the I3uilding Otficial 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 possible, 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 Numbei: (952) 249-4616. Also,you can call allead oF time to�nake <br /> sure we received the fax,or to wain us that the fax is coming. <br /> 3. WATER METERS ►nust be set and sealed by Orono ��'ater Department (952) 249-4600, <br /> upon comptetion 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: ,�� �����-� �� � � l�� � � � ���� �r'`' �„��� <br /> J ,1= <br /> � . <br /> Owner: ��� � �` i� '� ��' l-'t C i�6�� / �' Mailing Address: <br /> � <br /> �t L c� �� � ' tc `'>�E • �- �� �., <br /> City: f l _ ��`° t �.:oc:�,t �/ Zip: � �_zz ,� --% -� r � <br /> c�.y�� �> <br /> �Iome Phone: ��C a� �� � �/=�(^'(� Altei-�iate Phone: <br /> Contractor Information: I <br /> � �� � f � <<� <br /> , �� � -,;r--_ <br /> Contractor: �c�!��<<�� �� �< < <�"�� � � �on�act��erson: <br /> Address: � �' � ���% ��� ��� J�'/State License #: <br /> � <br /> City: ��� �l �r�'� Zip:SS�����Expiration Date: <br /> Phone: ��� � ��7� - �J����� Alternate Phone: <br />