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[ .4 <br /> R C V VSE ONLY <br /> City of Orono oma' <br /> P.O.Box 66 DateReceM Permit# aO 1S <br /> �./ 2750 Kelley Parkway <br /> Crystal Bay,MN 55323 Approved By:(If Required); <br /> (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 IN ORMATION <br /> I. WATER METERS must be picked up and paid for at City Hall. <br /> 2. Uggssibl,e 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 A l - <br /> Residential(May Require Approval) ❑Commercial(Approval Required) <br /> New Meter ❑Additional Meter—For: ❑Replacement Meter <br /> JJoob,'Sitc,C O...Vmer Information:. <br /> Site Address: ® 0►--�°`k4-r'n R� �5e'5 <br /> �°� � � LLQ., <br /> Owner: Mailing Address: S So ZSR r V <br /> City: Zip: Sf- Cto L*- IVIKD <br /> Horne Phone: Alternate Phone: ---� <br /> Contractor Information: <br /> N r ACV,*k...A— � J <br /> Contractor: p( l i T—i c . Contact Person: v� �. 1•,S e�,^�, <br /> �. -set o iz V" 1z,,-e, g <br /> Address: State License#: P C_ l0 4 2-ir T-j <br /> City: Zip:LoJ Expiration Date: n- 1%!r <br /> Phone: �? �'3 -1 3-3 11'41 Alternate Phone: L 11...-L t) -1 d 3'7 <br />