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I,. I' 1 <br /> r � <br /> FOR CITY USE ONLY <br /> City of Orono s—(— <br /> /V Y P.O.Box 66 Date Received: Permit o —��T J <br /> 2750 Kelley Parkway <br /> w ' r Crystal Bay,MN 55323 Approved By:(If Required): <br /> •�`, (952)249-4600 <br /> CITY OF ORONO—WATER METER FORM <br /> (*Note:Some permits may require approval by the Building Official and/or Public Works Department 5) <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 /> ❑New Meter ❑Additional Meter—For: 0 Replacement Meter <br /> Job Site I Owner Information: <br /> Site Address: �) O(c� C 4-61 Aty &ODYN I'j0ft�'I-� <br /> Owner: P/C(#t CoreS Mailing Address: _ at, .4.040 3e0 <br /> City: Mi l/ I S Zip: I/O 3 <br /> Home Phone: 1®(c "l R 0 h/tb Alternate Phone: <br /> Contractor Information: <br /> Contractor: ,4$'O vl Contact Person: <br /> Address: J6-1i .Hi 9 5,01,1/1 State License#: (L,7 ' / ' <br /> City: Zip:. ..3q3 Expiration Date: <br /> Phone: "l �� 7U d Z.�/ Alternate Phone: 6/ '-'614/--q3 -61 <br />