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T WATER METER PERMIT' ES" <br /> WILL BE� [TLULA'FED BY CITY STAFF . <br /> ❑ 5/8"METER- ❑ 3/4"METER- ❑ 1"METER- <br /> [3 5/8"HORN - ❑ 3/4"HORN - ® 1"HORN - <br /> ❑ "WATER METER (THESE WILL HAVE TO BE SPECIAL ORDERED&PRICES DETERMINED) <br /> 1. METER FEE: $ Io?.3 SF• 4 1 <br /> 2.-NQW4-ft� Pl�e !tet $ 0,B$ <br /> 3. TOTAL PERMIT FEE(Add Lines 1-2 Above) <br /> CITY-USE ONLY <br /> * For Current Pricing Refer to Current Year-Water Meter Pricing Chart <br /> BRAND: /V u e <br /> SIZE: E15/8" ❑3/4" ❑ 1" ❑Other _" <br /> SERIAL#: -70,235 957 3 <br /> ERT HIGH#: 010111 Mul 11111111111 applicable) <br /> 1831271458 (if pp ' able) <br /> 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 11 statements made on this application are,true and correct. <br /> Applicant: Date: 0 6 <br /> � :Reset•�Fvrmi <br /> Original: I-Address File <br /> Make Copies For: I- Utility Billing Department I-Cash Drawer <br />