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�C�USE ONLY <br /> O,¢��O CityofOrono �� �/� G <br /> P.O.Box 66 Date Receive Permit#UfI/�7' ,3A�� <br /> 2750 Kelley Parkway <br /> a r"'*• +� Crystal Bay,MN 55323 Approved By:(If Req�ired): <br /> �� ��' '�� �� o� (952)249-4600 <br /> � ��oe�' <br /> CITY OF ORONO-WATER METER FORM <br /> (*Note:Some permits 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. I�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 sea►ed 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 /> ❑ New Meter � Additional Meter—For: �Replacement Meter <br /> C�Y�� �Y�� h�,E?}-2.% l,�n <br /> Job Site/Owner Information: -�,-��-.,.— ,�,�.,,��Z.c�y,�.e._ <br /> Site Address: a-7 flE� �-�h�� � �-� '�� <br /> Owner: �j�-�t�%1`1�C Mailing Address: <br /> 1.�;5��-�a ��c'�: v��� r'�'1� I��t�' <br /> City: �� Zip: <br /> Home Phone: Alternate Phone:� <br /> �� a-� ��7- �33I <br /> Contractor Information: <br /> Contractor: �C3n��L'-��.�,Nw9rj►�e, Contact Person: .�,�,•{f" �t-'G ��1i1� <br /> Address: �-(oS C� Y2�. t�� r�; � State License#: (�(P���.� Ym' <br /> City: �'C>�t,✓`� Zip:5��Expiration Date: i�'j! �ZU��1 <br /> Phone: �� �e�� <br /> �15;�-�-11'o1-�j Lfh� Alternate Phone: ���- �U-��1�) � <br />