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,� � ' � � <br /> t ,� �/ <br /> CIT U5E ONi�Y <br /> �O . ` City of Orono � �f�O l� � <br /> 1�O P.O.Box 66 Date Receive Permit# <br /> 2750 Kelley Parkway <br /> Crystal Bay,MN 55323 Approved By:(IfReq ired): <br /> (952)249-4600 <br /> �`��.�kF o�ti�'� CITY OF ORONO—WATER METER FORM <br /> S H (Note:Some permits may require approval by the Buildmg Offic�al and/or Pubhc Works Department) <br /> GENERAL 1NFORMATION <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)249-46]6. 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 /> (Chec�All That A 1 ) <br /> [�Residentia] (May Require Approval) ❑ Commercial(Approval Required) <br /> [�1Qew Meter ❑ Additional Meter—For: ❑ Replacement Meter <br /> Job Site/Owner Information: <br /> Site Address: v��� S � ���1 ���c, � Q���'�+l � C:��'C <br /> Owner: Mailing Address: <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> Contractor: � ��S C O ��--I`� Contact Person: �� ( «�/ <br /> Address: 7 ��'� �i � �� �-�%� �'� State License #: l��l ��� <br /> City: � �'��� Zip: �S 3S� Expiration Date: �������� <br /> Phone: �DI Z' 3�0�1 -����� Alternate Phone: <br />