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� . ~ �r �V��� <br /> FOR CITY USE'ONLY ' <br /> City of Orono <br /> �-O�O P.O.Box 66 Date Received: Permit# <br /> 2750 Kelley Parkway <br /> Crystal Bay,MN 55323 Approved By:(If Required): <br /> (952)249-4600 <br /> y� �' <br /> �qx�SH��F.�' CITY OF ORONO-WATER METER FORM <br /> (*Note:Some permiu may require approval by the Building Official andlor Public Works Department <br /> *� <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 OF PERMIT <br /> (Check All That'A 1 ) <br /> �Residential(May Require Approval) ❑ Commercial(Approval Required) <br /> �New Meter ❑Additional Meter—For: ❑Replacement Meter <br /> 7ob Site/Owner Information: ` <br /> Site Address: Y V� 0 <br /> wner: `� Mailin Address: ll1� ��''� <br /> O � g <br /> ��ty: -�. Z�p: SS 3�i 1 <br /> Home Phone: <br /> 6 a '�/�o ���� Alternate Phone: <br /> Contractor Information: <br /> .- . I�,� <br /> Contractor: U�'1�� Contact Person: � <br /> ]Q��J� � <br /> Address: f ( � � � 1 ��-'"State License#: �� ��� <br /> � �53'�� 3� <br /> City: �� �C���p: xpiration Date: I� �� <br /> Phone: �l9�7 ' "�l�'��33 Alternate Phone: <br />