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Patrieia Bourgeois Ext692 (2/3) 08/30/2016 08: 13:48 AM -0500 <br /> t <br /> � C�k��.�.D�'' �� ��� <br /> FOR C USE ONI.Y <br /> ���0 P.0 gox Oroao Dace Rece ����Permit#1�4J�1U� +v� <br /> 2750 Kelley Parkway <br /> Crystal Bay,NIN 55323 Approved By:(Tf Required): <br /> (952)249-4600 <br /> S � <br /> F�9kFSH���G CITY OF ORONO—WATER METER FORM <br /> (Note:Some permiu ma}requiro approval by the Building Official and/or Public Works Department) <br /> GENERAL INFORMATION <br /> 1. WATER METERS must be picked up an�paid for at City Hall. <br /> 2. If possible,fax in this application ahead of time;we will then cal]you and let you know we have <br /> the water meter in stock. Fax Number:(952)249-4616. Also,you can call ahead of rime to make <br /> sure we received the fax,or to wam us thAt the fax is coming. <br /> 3. WATER ME;TERS must be set and sealed by Orono Water Department (952) 249-46Q0, <br /> upon comptetion of ineter installation. <br /> TYPE OF PF,RMTT <br /> Check.AII That A 1 <br /> ❑Residential(May Requirc Approval) ❑Commercial(Approval Rec{u'uecl) <br /> New Meter ❑Additional Meter—For: ❑Replacement Meter <br /> � <br /> Job Site/Owner Information: <br /> Site Address: ��-3� ��S C... �Q.. <br /> �, <br /> Owner: ��e�\1�.5�Ccxr�. �.rc�,�.,t \lU,^�w� Mailing Address: <br /> City: Zip: <br /> Iiome Phone; Alteniate Phone: <br /> Contractor Information: <br /> Contractor: '�1 C �V�C�\(xn,Cc�� �,Y'�,,(:ontact Person: DJ�`�t},5 <br /> Address: ,1e�}11 ��¢rr E1 C\ �-�l� State License#: C`p��"J�J�j� <br /> City: �(��`�L�.�__ ��P�k� Expiration Date: I 2-�J� �[� <br /> Phone: ���a_�_��-�} Alternate Phone: <br />