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a . � <br /> F C Y USE ONLY <br /> ��0�� City of Orono 2// <br /> �1 ¢ �� P.O.Box 66 Date Received /� Permit# aa� r ��J� <br /> �/ ' '� �' 2750 Kelley Parkway <br /> (� ».... .,. <br /> )j�.'x;" II Crystal Bay,MN 55323 Approved By:(IfRequired): <br /> \�?�'-"'r-�i•�,� (952)249-4600 . <br /> ���xos '� �—, <br /> �,___ �% <br /> CITY OF ORONO-WATER METER FORM <br /> (*Note:Some pennits 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. Ifpossible, 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 sealed 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 /> Job Site/Owner Information: <br /> Site Address: �I�� ��q�+r�s ����,.�' �oc� <br /> Owner: /" I ��".� Q a:G 9S Mailing Address: <br /> City: U ro y,,b Zip: � � ��� <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> Contractor: ���'� �rv��,l� Contact Person: � ��-�� <br /> J <br /> Address: y'SZv �� rS-f-r� �5tate License #: ���(Q �� <br /> City: Zip: / '""' Expiration Date: ��-" 3/- /� <br /> Phone: 7�3 "5'�1 ��37 Alternate Phone: �a' �3�- �'S%�' <br />