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f <br /> FOR CITY USE ONLY <br /> ��,¢� City of Orono <br /> fO r` Q\ P•O.Box 66 Date Received: Permit# <br /> y,,� � 2750 Kelley Parkway <br /> '��1�,``.. C stal Ba MN�53?3 A roved B lf Re uired <br /> � ����,;� �'� rY )'� PP Y�� 9 )� <br /> \ �j�:i,�}�c (952)249-4600 <br /> �t:�ir..,r�$�. . <br /> �tp%o <br /> -z- <br /> CITY OF ORONO—WATER METER FORM <br /> (*1\ote:Some permits may requirc 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 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 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 /> ❑Kesidential (May Require Approval) ❑ Commercial (Approval Required) <br /> ❑ New Meter � Additional Meter—For: �Replacement Meter <br /> Job Site/Owner Information: <br /> Site Address: �� �'���''�`�' � - / `� • <br /> Owner: ��f�� �i►"�✓W�G-�� � <br /> Mailing Address: <br /> City: �i�'�'�=� Zip: `� ��r'l � <br /> Home Phone: _��L� ���'�?�� Alternate Phone: (� ��' ((���0 r ( ��� <br /> Contractor Information: <br /> Contractor: Contact Person: <br /> Address: State License #: <br /> City: Zip: Expiration Date: <br /> Phone: Alternate Phone: <br />