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FOR CITY USE ONLY <br /> O�D�O City of Orono <br /> P.O.Box 66 Date Received4�oPermit# <br /> 2750 Kelley Parkway <br /> 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*) <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 wain us that the fax is coming. <br /> 3. WATER METERS must be set and sealed by Orono Water Department (952) 2494600, <br /> upon completion of meter installation. <br /> TYPE OF PERMIT <br /> (Check All That Apply) <br /> Residential(May Require Approval) ❑ Commercial(Approval Required) <br /> XNew Meter ❑Additional Meter—For: ❑Replacement Meter <br /> Job Site/Owner Information:' <br /> Site Address: C,-W-to� � �4-:5 PQ C+ <br /> Owner: V �l�G(,�_ ��ii/��j el Mailing Address: <br /> City: , L��G J l b{� Zip: J��� <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> Contractor: LAO Nokjj� Contact Person: <br /> Address: ?f 00r✓Iw�t,�-�S {` State License#: <br /> City:, rri 5 Zip: 6 SZ Expiration Date: Z- 3 l - 0 C¢ <br /> Phone: b'01-a I Alternate Phone: <br />