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. ' <br /> FOR CITY U$E ONLY <br /> �O�TO City of Orono <br /> 1 y P.O.Box 66 Date Received: Permit# <br /> 2750 Kelley Parkway <br /> Crystal Bay,MN 55323 Approved By:(If Required): <br /> (952)249-4600 <br /> �`��.�kFs oR�,�'� CITY OF ORONO—WATER METER FORM <br /> H (Note:Some permits may reqwre approval by the Buildmg 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]et 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 /> (Check All That A 1 ) <br /> Q Residential(May Require Approval) ❑Commercial(Approval Required) <br /> � New Meter ❑ Additional Meter—For: ❑ Replacement Meter <br /> Job Site/Owner Information: <br /> Site Address: �S�C � t�.-e l I�,� t`�1 v � <br /> Owner: Mailing Address: <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> Contractor: ��t S � `' ����� Contact Person: �'��� � <br /> Address: � Cl� S � � �'�`��� � �` State License #: U �� �'� v <br /> City: � � �"c�`-' Zip:SS35`7 Expiration Date: ��f 3� �7 <br /> � <br /> Phone: 1 � �Z��(�1 S��C.� Alternate Phone: <br />