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� d, r 1 $i m 6 6 F I i #"aim a *.� � � ry$arx rr <br /> ¢p <br /> z kwr. a ''z -, #ar r* Y+,? �"' 4. ? . <br /> 4(z- jer <br /> ❑ 5/8"METER- Or 4"METER- ❑ 1"METER- <br /> ❑ 5/8"HORN - 14 /4"HORN - ❑ 1"HORN - <br /> El "WATER METER (THESE WILL HAVE TO BE SPECIAL ORDERED&PRICES DETERMINED) <br /> 1. METER FEE: $ 3 7 C <br /> 2. HORN FEE $ - . (P <br /> 3. TOTAL PERMIT FEE(Add Lines 1-2 Above) $ — 0 • <br /> CITY-USE ONLY <br /> * For Current Pricing Refer to Current Year- Water Meter Pricing Chart * <br /> BRAND: /' 1-1A.471 <br /> SIZE: ❑ 5/8" K1 3/4" ❑ 1" ❑ Other " <br /> SERIAL#: 5 A4070 g' <br /> ERT HIGH#: III III IIII II II II III III I III III (if applicable) <br /> 1834496268 <br /> ADDITIONAL INFORMATION-WATER METERS <br /> The undersigned hereby applies to the City of Orono for issuance of a water meter permit, agrees <br /> to do all work in strict accordance with the ordinances of the City and the regulations of the State <br /> of Minnesota, and certifies that .11 statements made on this application are,true and correct. <br /> Applicant: If p Date:/D'-o? 1 <br /> Original: 1-Address File <br /> Make Copies For: 1- Utility Billing Department 1-Cash Drawer <br />