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FOR Ct�'Y USE ONLY <br /> � City of Orono � <br /> O¢ �O P•O.Box 66 Date Recei�ed: �0 Permit#� ���"' 0 a� <br /> 2750 Kelley Parkway <br /> � ��, ;,`� Crysta]Bay,MN 55323 Approved By:(IfRequired): <br /> �� (952)249-4600 <br /> �09 <br /> CITY OF ORONO—WATER METER FORM <br /> (*Note:Some permits may require approval by the Building Official and/or Public Works Deparhnent*) <br /> GENERAI,INFO'RMATION ' <br /> 1. WATER METERS must be picked up and paid for at City Hall. <br /> 2. If nossible,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 OF PERMIT <br /> (Check Al1t'That A. 1 ` <br /> ❑Residential(May Require Approvai) ❑ Commercial(Approval Required) <br /> ❑ New Meter ❑Addirional Meter—For: [�Replacement Meter <br /> 7ob �ite/Owner Inforrnatian: ' <br /> Site Address: 3 �J V 1 �S�V�, �}V�h,l,� rt', <br /> Owner: �-�►�I. � �1� Mailing Address: .� 7-'-i3 �! 1/( J� 5�1 ��/�, <br /> V <br /> c�ty: zip: ��r' 3q 1 <br /> Home Phone: Alternate Phone: <br /> Contractor Tnfornzation: <br /> C ccv l cJ �-S a✓� S �/� <br /> Contractor: �e�� aK•crti. F'�vt�c.�t�-�, Contact Person: / "��l�- <br /> Address: �`�2`� � ' 3� 5t �� State License#: /"C ��T <br /> I / <br /> City: `� Zip� y�� Expiration Date: <br /> Phone: �� �ss �o��g Alternate Phone: <br />