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�- <br /> ' � FOR CITY L'SE ONLY <br /> ,���, City of Orono <br /> P.O.Box 66 Date Received: Permit# <br /> ��;;�{»� � 2750 Kelley Parkway <br /> �� ��.�`,-'. F Crystal Bay,MN 55323 Approved By:(If Required): <br /> ����,�A��o` (952)249-4600 � <br /> a <br /> CITY OF ORONO—WATER METER FORM <br /> (*Note:Some permits 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 osp sible,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 All That Apply) � � <br /> �Residential(May Require Approval) ❑ Commercial(Approval Required) <br /> ,� New Meter ❑Additional Meter—For: ❑ Replacement Meter <br /> Job Site / Owner Information: <br /> Site Address: �C�� �'�� ,�� ���,�G�c{� � <br /> Owner: C�v1r� 1� y� Mailing Address: <br /> City: ��'��� Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> Contractor: �cc✓'� 1,�,1� ���✓JS Contact Person: �r Q 1�1������'�V�Sv 1�J <br /> Address: �n ��f� J.�l� �j/'rh1�i�State License#: 2.. �� d�j��� <br /> City: �C. Zip:� Expiration Date: <br /> Phone: ��, �7 � ���� Alternate Phone: �n l��-�C�(o��� <br />