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FOR CITY USE ONLY <br /> O¢OO City of Orono <br /> P.O.Box 66 Date Received: Permit# <br /> 2750 Kelley Parkway <br /> Crystal Bay,MN 55323 Approved By:(If Required): <br /> (952)249-4600 <br /> 'mOx� CITY OF ORONO—WATER METER FORM <br /> (*Note:Some permits may require approval by the Building Oficial and/or Public Works Department') <br /> GENERAL INFORMATION <br /> 1.' WATER METERS must be picked up and paid for at City Hall. <br /> 2. If possible fax in this application ahead of time;wevill then call you and let you know we have <br /> the water meter in stock. Fax Number:(952)2494616. 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) 2494600, <br /> upon completion of meter installation. <br /> TYPE OF PERMIT <br /> Check All That Apply) <br /> ❑Residential(May Require Approval) ❑Commercial(Approval Required) <br /> New Meter ❑Additional Meter—For: ❑Replacement Meter <br /> Job Site/Owner Information: <br /> Site Address: t�' ©�� czi 'gl(-eq�l01 <br /> Owner:0/°OX4 SCA-®D 1-r Mailing Address: <br /> City: ��� Zip: � <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> Contractor: uj-/-/A6&V Contact Person: <br /> Address: 0 /P� State License#: <br /> City: Lor, c� oZO ZipS5-5S-'P Expiration Date: <br /> Phone: Alternate Phone: <br />