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� _ � <br /> - <br /> FOR CITY'USE ONLY <br /> Q,���O City of Orono <br /> P.O.Box 66 Date Reeeived: Pennit# <br /> 2750 Kelley Parkway <br /> �� ,- r Crystal Bay,MN 55323 Appmved By;�If Requiredj: <br /> �0� (952)249-4600 <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:INFQF.IVIATIOI�i ' <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 lmow 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 Th�t 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: ��6g �. �� . � (�. <br /> Owner:l►1����1 E �P,r�W p�� Mailing Address: <br /> City: ��4 2�A- Zip: S53`� I <br /> Home Phone: �s2-g��-09g� Alternate Phone: co��.- g�S- IOS�- <br /> Contractor Informatian: ` <br /> Contractor: �:� �ss� � l.�c Contact Person: ¢..�� �SS�L <br /> Address: �7�� �� Ln1 State License#: �7.��`7 <br /> City: (I�a�Nn Zip�,�,� Expiration Date: 3'3 i - O`� <br /> Phone: 952-�7�-�(�g Alternate Phone: �o12-Sb'I � y�s� <br />