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s <br /> ! •• ♦ <br /> FOR CITY USE�1VLY <br /> �O . ` City of Orono <br /> 1VO P.O.Box 66 Date Recei�ed: Permit# <br /> 2750 Kelley Parkway <br /> Crystal Bay,MN 55323 Approved By:(IfRequired): <br /> (952)249-4600 <br /> � a, <br /> ti�, ` <br /> �qk�SHp�F.�' CITY OF ORONO—WATER METER FORM <br /> (*Note:Some permiu may require approval by the Building Official and/or Public Works Department <br /> s� <br /> GENERAL 1NFORMATION <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 PERIVIIT <br /> (Check All That A 1 ) <br /> ❑Residential(May Require Approval) ❑ Commercial(Approval Required) <br /> �New Meter ❑Additional Meter—For: ❑ Replacement Meter <br /> Job Site/ Owner Information: ' <br /> Site Address: �/ �� /���'�r� �'� <br /> -� <br /> Owner: �2 0'�� �4 G� �-S�. Mailing Address: <br /> City: �1 oU �� � Zip; .�'�S 7j 6 � <br /> Home Phone: � G S � , 2 7� ��� ��Alternate Phone: <br /> Contractor Information: <br /> Contractor: �e r�ev �/'a�,�Ov Contact Person: �� ��� ��/�v� <br /> Address: �6��� � � State License#: ��-� � �2� �S �l <br /> City: ����tI�e M�Zip:�5 3��Expiration Date: �2����2-� ��� <br /> Phone: ��5 2- 3`r 3 ��272 Alternate Phone: �`�S 1 1 ��y— � �6 v <br />