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� <br /> Fo�crr�usE ori�.Y <br /> ��A T City of Orono f� l�—1 � ��� /" ` C�� �� <br /> 1 yO P.O.Box 66 I3ate Received: ` Perrr�it# � <br /> 2750 Kelley Parkway <br /> Crystal Bay,MN 55323 Ag{�rQ�d By:(lfitequiredj: <br /> (952)249-4600 <br /> ��`�xFs o��'G� CITY OF ORONO —WATER METER FORM <br /> H (Note:Some perm�ts may require 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 ossible, fax in this application ahead of time;we will then call you and let you lrnow 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 OF PERMIT <br /> Check All `That A 1 <br /> ❑ Residential(May Require Approval) ❑Commercial(Approval Required) <br /> -�e.w Meter ❑Additional Meter—For: ❑ Replacement Meter <br /> �� <br /> Job Site/Owner I�formation: <br /> ,� i"�� <br /> -, <br /> L � �-'"'=;r ,----°-� _ 1 ; <br /> Site Address: � —' ' � � �� �� SCo � //'c:�� <br /> Owner: ���2���i���r Mailing Address: >�3� «-f���' ��=-�� <br /> � � --._. <br /> City: �t/lu, Z� Zip: S � -`� %/ <br /> Home Phone: �l-2 ��� � �'�-' Z- Alternate Phone: �/-� S 7 �' � �� �j <br /> Contractor Information: <br /> Contractor: Contact Person: <br /> Address: State License #: <br /> City: Zip: Expiration Date: <br /> Phone: Alternate Phone: <br />