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�T City of Orono / i# ONLY <br /> WPOBox66 Date v+72750 Kelley Parkway <br /> Crystal Bay,MN 55323 By:( itequire d): <br /> (952)249-4600 <br /> o4CITY OF ORONO-WATER METER FORM i SA`O <br /> SH (Note:Some <br /> (N 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 /> 0 Residential(May Require Approval) ❑ Commercial(Approval Required) <br /> 0 New Meter D Additional Meter—For: 0 Replacement Meter <br /> Job Site/Owner Information: <br /> Site Address: - kV9,1/"Ice,) t/ <br /> Owner: v12Cry l i;6->za Mailing Address: 22 - yr ('( <br /> City: CLx`ro Zip: 5-73 5 <br /> Home Phone: Z/2---2 o Y23? Alternate Phone: <br /> Contractor Information: <br /> if <br /> Contractor: !l -� Contact Person: - "' t `? <br /> Address: ►"mc'ti /tate License#: GCZS.--? -/ 7/4 <br /> City: a-�-IiC7 Zip:5 33 Expiration Date: 12-/3(/ii <br /> Phone: g/2 - 2YU ^�5' Alternate Phone: &Z _28O-MA <br />