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�� <br /> � . , � �� ���v�� �� <br /> � � . <br /> � F�12 CITY USE ONi.Y '� <br /> • � City of Orono r. � � � � = �� �� <br /> �-O�O P.O.Box 66 Date Reccived: �� �T�"� Permit# � I f <br /> 2750 Kelley Parkway ,., <br /> Crystal Bay,MN 55323 Ap}�o�ed By:(�#'��quir�d): � �,� <br /> (952)249-4600 <br /> ���.�kFs a��.�'� CITY OF ORONO —WATER METER FORM <br /> H (Note:Some permrts may requve approval by the Building 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 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 4F PERNIII'T' <br /> Che�k All That A 1 <br /> 1�Residential(May Require Approval) ❑ Commercial(Approval Required) <br /> r� <br /> �New Meter ❑Additional Meter—For: ❑ Replacement Meter <br /> Job Site/Ov�ner Infonnation: <br /> Site Address: � � � � �-��S��C� �����'� � <br /> � 7 r _ <br /> Owner: _ r�C�t.� J i� � pC�� Mailing Address: ���/ �--r� �� �i'Ll-� <br /> ! <br /> CitY: %L�� � Zip: � ��� �� <br /> ��.� 7�`� -��Y/ <br /> Home Phone: ,�/� ��-�U�S�Z Alternate Phone: ,���_ �5 � 8 ���� <br /> Contractor Itsformation: <br /> Contractor: Contact Person: <br /> Address: State License #: <br /> City: Zip: Expiration Date: <br /> Phone: Alternate Phone: <br />