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,r <br /> FOR C(TY USE ONLY <br /> City of Orono -��'._. � <br /> ���� P.O.Box 66 Date Received���l����fPermit# � C-`�(�� - �7 (�- �, <br /> � 2750 Kelley Parhway <br /> Crystal Bay,MN 55323 Approved By:(If Required): <br /> (952)249-4600 <br /> �� ` . <br /> `qk.F1No�``� CITY OF ORONO—WATER METER FORM <br /> �- (tiote:Some permits may require approval by the Building Of�ficial and/or Public Works Department) <br /> GENERAL INFORMATION <br /> I. 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. Far 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 faY 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 /> �f Residential(May Require Approval) ❑ Commercial(Approval Required) <br /> (�New Meter ❑ Additional Meter—For: ❑ Replacement Meter <br /> Job Site/Qwner Information: <br /> Site Address: �J~� <br /> Owner:/ _� Mailing Address: Co���7 �,C L��C /.� -� <br /> City: i�/�ti1 , � Zip: �3� <br /> Home Phone: �oZ--3S�'-b�3 Alternate Phone: �2-f�"j- -��� <br /> Contractor Information: <br /> Contractor: .��f��(.CC�e /.��� ontact Person: � <br /> Address: /5�� State License#: p �7��T/ <br /> City: ��2c.�.c-- Zip��� Expiration Date: � ✓��e�J71 <br /> Phone: �3�G�y�d7 Alternate Phone: �i7�y�7`�d�J <br />