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� FOR CITY USF,ONLY <br /> ,���� City of Orono � <br /> P.O.Box 66 Date Received: Permit# <br /> �"� � 2750 Kelle Parkwa <br /> � Y Y <br /> � ��'�'�,�.'�. � Crystal Bay,MN 55323 Approved By:(If Required): <br /> t� ��r��,�o (952)249-4600 <br /> i'gasaoa <br /> CITY OF ORONO —WATER METER FORM <br /> (*Note:Some permits may require approval by the k3uilding 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 rime; 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 ineter installation. <br /> TYPE OF PERMIT <br /> (Check All That Apply) <br /> �Residential(May Require Approval) ❑ Commercial(Approval Required) <br /> ❑ New Meter ❑ Additional Meter—Far: ❑ Replacement Meter <br /> Job Site/Owner Information: <br /> Site Address: ���}�-' �tz�c� ��• ('�-�. <br /> Owner: v�,,�ce.���<,� �UN Mailing Address: <br /> City: blQn 1� Zip: <br /> Home Phone: Alternate Phone: <br /> Contractar Information: <br /> Contractor: tJ� N/���t I�L�µ�,n��:� Contact Person: i�;� ,��,;,,; ( <br /> Address: 43ac� C��r��-k State License#: � <br /> City: ��"--�5 Zip: Expiration Date: <br /> Phone: �.1r/— 7�S '7bsy Alternate Phone: <br />