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Ili CITY Ute WEN <br /> City of Orono <br /> WPO.Box 66Received. f Wit#vu��'Q���ii <br /> 2750 Kelley Parkway ,kCrystal Bay,MN 55323 Approved�y:(WR r :1 <br /> (952)249-4600o4 � CITY OF ORONO-WATER METER FORM <br /> SH (Note:Some <br /> 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. If possible, 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) 0 Commercial(Approval Required) <br /> 0 New Meter 0 Additional Meter—For: Replacement Meter <br /> Job Site/Owner Information: <br /> Site Address: 1755 Co nc-0 acSL cam. 2 (-- <br /> Owner: Dc', CA11_0(y 665 Mailing Address: <br /> City: Cw --(-)/ L.,-)1 z—tom Zip: 5S 39 I 93/c; <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> Contractor: OcC I` C t Npo Ulu' ontact Person: dACo J g c►e Le.K <br /> Address: 41 U Visi,en <br /> State License#: tplo7 5c - P m <br /> City: t (I[Wlit5S Zip: 653+ Expiration Date: 12115 <br /> Phone: 62(A- °;---i37 Alternate Phone: d15P-935-5150 <br />