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� <br /> FOR CITY USE ONLY <br /> 0,���0 City of Orono — — <br /> P.O.Box 66 Date Received: Permit# <br /> '� 2750 Kelley Parkway <br /> � �; '�'. � Crystal Bay,MN 55323 Approved By:(►fRequircd): <br /> •����a (952)249-4600 <br /> �rresog� <br /> CITY OF ORONO—WATER METER FORM <br /> (*Note:Some pemiits may require approval by Ihe 8uilding Offcial and/or Public Works Department") <br /> GENERAL INFORMATION <br /> 1. WATER METERS must be picked up and paid for at City I3a11. <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 ca�call ahead of time to�nake <br /> sure we received the fax,or to wain us that the fax is coming. <br /> 3. WATER METERS must be set and sealed by Orono Water Department (952) 249-4(00, <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: ' ����_ �'�t'�1� ���1�E � L ��.�r�� �-�'�I lr' <br /> Owner: ��j�;_�1_i , ,� t �; ;�' ��_I�ItJ MailingAddress: ,;�:, � � <br /> � ,�.X ?S�, <br /> City: �_� .�� ���; Zip: , � , t ;� <br /> . <br /> Home Phone: �j 1��,,�'�� %�� -(1 �� { A?temate Phone: <br /> Contractor Information: <br /> Contractor: ��-��,,tavt- �1�Yt'lY����-�C.t�C. ContactPerson: �7^n �.�� <br /> Address: 1�Z�� �_I� 1��r1� i�� State License #: (��(1�-�2 i r� �lr}1 _ <br /> , <br /> City: 7,ip:r�rri�y Expiration Date: I Z�"�t f C'`] <br /> � <br /> Phone: �Io�-��-{Z..`�S-! �5��� Alternate Phone: <br />