HomeMy WebLinkAboutsale/water meter (Updatecl 01/12/04)
CITY OF ORONO SALE OF WATER METER
��,x 66 (2 i 50 Kclicy rarxway)
Crystal Bay, MN 55323
GENERAL INFORMATION
1. Water meters must be picked up and paid for at City Hall.
2. Water meters must be set and sealed by Orono Water Department(952-249-4600)upon
completion of ineter installation.
JOB SITE ADDRESS: � 5 � ���4 w�� S �2%'`.:�
Occupancy Type: �Residential Commercial
Owner'sName�U�ti ��' �' �� �`� _ �G kc ss phane Nun�ber:
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Mailing Addi-ess: Ci�y: Zp:
Contractor's Name: j G�C��'�-' ��`��_ plione Number: ���� �� 4` y S-����
Mailing Address: �-��C% S �'� � �ws _�� City. `� S_`�� �
. , p/� 71p.
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METER INFORMATION
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(5/8° meters = $210.00; 3/4" meters = $250.00; 1" meters = $320.00)
Serial Number: I��I o�� �� � S ERT # 03- '�a a L���� � �
� � �
Size: �� Brand: ��x c( �2 T�e. ` ?x-K �, C ('��`�
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Meter Fee: $ � � � _ G C�
Si�nature of A licant ' %��
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� Pp - ��'' Date: �- —�O •– c�_�
Make Copies For: 1-Address File 1-Utility Billing Dept 1-Cash Register
V:\(Forms)\Watermeter Sale Form.wpd