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FOR CITY USE ONLY <br /> City Orono <br /> P.O.Box <br /> 66 Date Received: Permit# <br /> 2750 Kelley Parkway <br /> Crystal Bay,MN 55323 Approved By:(If Required): <br /> (952)249-4600 <br /> `AkESHO �G 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. Ifosp 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 meter installation. <br /> TYPE OF PERMIT <br /> Check All That Apply)'. <br /> [residential(May Require Approval) ElCommercial(Approval Required) <br /> /❑New Meter ❑Additional Meter—For: Replacement Meter <br /> Job Site/Owner Information: <br /> Site Address: 359® N10k- i FdW y t 09=42 I <br /> Owner:t(Z U Mailing Address: 5590 <br /> City: ®IZori t Zip: <br /> Home Phone: (0Og'335-1 Z7 S Alternate Phone: <br /> Contractor Information: <br /> Contractor: Contact Person: <br /> Address: State License#: <br /> City: Zip: Expiration Date: <br /> Phone: Alternate Phone: <br />