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FOR CITY USE ONLY <br /> City of Orono <br /> 0,04P.O.Box 66 Date Received: Permit# <br /> 2750 Kelley Parkway <br /> Crystal Bay,MN 55323 Approved By:(If Required): <br /> °tAl 4o (952)249-4600 <br /> o <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 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 OF PERMIT <br /> (Check All That Apply) <br /> ❑Residential(May Require Approval) ❑ Commercial(Approval Required) <br /> KNew Meter ❑Additional Meter—For: ❑Replacement Meter <br /> Job Site/Owner Information: <br /> Site Address: <br /> Owner: Mailing Address: <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor Information: <br /> • Contractor: &cLk -tiLi ot- / k-e Contact Person: & � r <br /> Address: / 35' 5-0 Rsr NO State License#: <br /> Q 5;x;1 e foo <br /> City: ,` S'e- Zip:55 .373 Expiration Date: <br /> Phone: -26; '2-66 2- Alternate Phone: 7J] -an- /736 <br />