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08/17/2015 11 :57 #3778 P. 001/002 <br /> or\ 4,i) A 4( <br /> (--:-4:6;cr-, <br /> RCl YUSEO 7nt,G--6 /0 . * <br /> Cityof 6rono � �D/�Q <br /> P.O.Iiox 66 Date Race /� Permit 3i <br /> 2750 Kelley Parkway <br /> 111 Crystal Say,MN 55323 Approved By"'°Required): 6 •O . _ / 8// VY <br /> (952)249-4600 <br /> �a ..�t; ':.;:,fit.l ' <br /> � <br /> �c CITY OF ORONO-WATER METER FORM lns�. TiL I IS <br /> K__ri_i (Note:Some permits may require approval by the Building Official and/or Public Works Department) <br /> GENERAL INFORMATIONw p�c Ituw <br /> ��. i li t`i <br /> 1. WATER METERS must be picked up and paid for at City Hall. ��Nv / ) '� ) <br /> 2. If possible,fax in this application ahead of time;we will then call you and let 'or-�IL <br /> the water meter in stock. Fax Number:(952)249-4616. Also,you can call ah "7 0, -, <br /> sure we received the fax,or to warn us that the fax is corning. <br /> 3. WATER METERS must be set and sealed by Orono Water Aepartm ®// //, 41V <br /> upon completion of meter installation. <br /> ../ <br /> D <br /> TYPE OF PERMIT <br /> (Check All That Appy) <br /> D Residential(May Require Approval) 14 Commercial(Approval Required) <br /> lt&I New Meter )151Additional Meter-For: tX'a i-a,4.;,,t, ❑Replacement Meter <br /> Job Site/Owner Information: <br /> Site Address: 4f O ik _eg-tfrt-ct.l ooy R.ot Aq <br /> Owner: .3-4?- 1,2, Mailing Address: <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor Information_ <br /> Contractor: Olt ri-ttekn Contact Person: 'Tal v 440,,,A.ssm.,e A �vts <br /> Address: i 9'c. �� 1 a4tcl State License#: pc 6-1 S$ <br /> City: &toll o...t Zip:`6c(expiration Date: 1�-- (S. <br /> Phone: C.S-1-7$5 4 al Alternate Phone: 651- 4.rr -g3 g <br />