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F R Y USE ONLY <br /> �O . ` City of Orono JI � <br /> 1�O P.O.Box 66 Date Receiv :� Permit#��6'' / <br /> 2750 Kelley Parkway <br /> Crystal Bay,MN 55323 Approved By:(If Requiredj: <br /> (952)249-4600 <br /> �F`-skF o��.�'� CITY OF ORONO—WATER METER FORM <br /> SH <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 far 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 /> ❑ Residential(May Require Approval) ❑Commercial(Approval Required) <br /> New Meter ❑Additional Meter-For: <br /> ❑ Replacement Meter <br /> Job Site/Owner Information: <br /> � <br /> Site Address: � O �� ��� c\��� <br /> Qe.,s�� ^. <br /> Owner: �� 5-�r Mailing Address: v2 i� ��� ���e�'-'�-'�-�1� _ <br /> �r�.� Y�� <br /> City: -�-�� ,c,�n c��-v� •c.. Zip: J��$`�' <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> Contractor: ��etc�sv� i'I+�c��,Hhi� ,ContactPerson: �„�{-�.. <br /> Address: 8 3 �� ���'��'�i�t State License #: � M�\ � i�% �.;��� <br /> City: �c�-K�� Zip::.�53c�3 Expiration Date: �e c_. :�.c��, <br /> Phone: ���" ���3� � ��a Alternate Phone: � �0 � �� 3 " 3� �� <br />