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POR diet' <br /> � City of Orono <br /> �i VrO P.O.Box 66 Permit <br /> t <br /> 2750 Kelley Parkway <br /> Crystal Bay,MN 55323 BY:Of 00 <br /> �kESHOR� (952)249-46CITY OF ORONO-WATER METER FORM <br /> (Note:Some 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 OFPyr <br /> (Check All That ) <br /> Residential(May Require Approval) 0 Commercial(Approval Required) <br /> IR'New Meter ❑Additional Meter-For: 0 Replacement Meter <br /> Job Site/Owner In": <br /> Site Address: 3(-177_ Lickc AJ e_ / -eisituc,.- ‘3 v:,l Atcs <br /> Owner: M -r O1 sa \ Mailing Address: <br /> City: D co'o Zip: SS 3, <br /> Home Phone: t9(2-99t-78.1 Alternate Phone: 1( <br /> Contractor Inf <br /> Contractor: t!e v-(-'7S`ti.o V , Contact Person: "^ Col-e. <br /> Address: 2k 330 CAesy-ty Ect State License#: CPC-4(43g63 <br /> ` <br /> City: 1�'a`'S `A ZipS5330 Expiration Date: ( Z/3 II/ 9 <br /> Phone: 7(9-3-St 6)- 4 2_9s Alternate Phone: < <br />