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4 <br /> W ftt <br /> : Q.7 u1+17.3$:iiJ iy ary t 4,Y : i % r <br /> 5/8"METER- ❑ 3/4"METER- ❑ 1"METER- <br /> ❑ 5/8"HORN - 0 3/4"HORN - 0 1"HORN - <br /> ❑ "WATER METER (THESE WILL HAVE TO BE SPECIAL ORDERED&PRICES DETERMINED) <br /> 1. METER FEE: $ 5--3. 00 <br /> 2. HORN FEE $ 3g -6o2 <br /> 3. TOTAL PERMIT FEE(Add Lines 1-2 Above) $ 33 5v cC' <br /> I CITY-USE ONLY I <br /> * For Current Pricing Refer to Current Year- Water Meter Pricing Chart * <br /> 1 <br /> "x 3/4 4_ <br /> BRAND: /J p+L l ✓t.e ED26511 x Sia" <br /> r <br /> SIZE: ,M/8"" 0 3/4" 0 1" ❑Other 19 36789311 <br /> 11111111 111111111 1111 I <br /> SERIAL#: 3(1)-7.73q31 I <br /> ERT HIGH#: I 5—y FO 9gto 7T (if applicable) 1548098678 <br /> 1 ADDITIONAL INFORMATION—WATER METERS <br /> The undersigned hereby applies to the City of Orono for issuance of a water meter permit, agrees <br /> to do all work in strict accordance with the ordinances of the City and the regulations of the State <br /> of Minnesota, and certifies that all statements made on this application are,true and correct. <br /> Applicant: ►_ A.,,....1.... <br /> 6 Date: f <br /> i <br /> Original: 1-Address File <br /> Make Copies For: 1- Utility Billing Department <br />