HomeMy WebLinkAbout2017-01381 - water meter .n
' CITY OF ORONO * z 0 1 7 - 0 1 3 8 1 *
2750 KELLEY PARKWAY DATE ISSUED: 10/24/2017
ORONO,MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2420 OLD BEACH RD
PIN : 21-117-23-22-0002
LEGAL DESC : SHORE HILLS
: LOT 001 BLOCK 000
PERMIT TYPE : WATER METER-RESIDENTIAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER METER-RESIDENTIAL
NOTE: INSEPCTIONS ARE DONE BY PUBLIC WORKS DEPARTMENT.
TO SET-UP AN INSPECTION,PLEASE CALL:(952)249-4600
1"NEPTUNE WATER METER
1545946042
53975097
WATER METER RESIDENTIAL HORN 1 WATER METER RESIDENTIAL 1
APPLICANT WATER METER RESIDENTIAL 372.06
WATER METER RESIDENTIAL HORN 144.64
B& D PLUMBING&HEATING INC. TOTAL 516.70
4145 MACKENZIE CT NE
ST MICHAEL,MN 55376- Payment(s)
(763)497-2290 CREDIT CARD 1070 516.70
Minnesota State License#: mech-MB003016
OWNER
SANGUINETTI,JOSEPH
2420 OLD BEACH RD
WAYZATA,MN 55391-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances goveming this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within l80 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
.
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Applicant Permitee Signature Date Issued B ignature Date
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T1i�V�.�'
City of Orono (� , .-, � � � � ���/
, �
�O�O P.O.Box 66 �Rcc�iv .�' P+�rsn�c#�v� � �
2750 Kelley Parkway �
Crystal Bay,MN 55323 A�prc�Sy:(If Ii�quicett�:
(952)249-4600
��`�kE o��'GZ CITY OF ORONO—WATER METER FORM
S H (]�Tate:Some permits may require approval by the Buiiding Official and/or Public Works Department)
G�NERAL iNFO�ATION
1. WATER METERS must be picked up and paid for at City Hall.
2. If possible, fa�c in this application ahead of time;we will then call you and let you know we have
the water meter in stock. Fax Number: (952)249-4616. Also, you can call ahead of time to make
sure we received the fax, or to warn us that the fax is coming.
3. WATER METERS must be set and sealed by Orono Water Department (952) 249-4600,
upon completion of ineter installation.
TYP�O�I'�Ri'�T'�"
Check All'T'hat A
�Residential(May Require Approval) ❑Commercial(Approval Required)
� New Meter ❑Addirional Meter—For: ❑ Replacement Meter
Job S�te/Owner Infflrm��ior�:
SiteAddress: �`�� � u�L�, jSC,��c(,-- �.��..��
Owner: Mailing Address:
City: �1�,�v a Zip:
Home Phone: Alternate Phone:
Contracto�Ir�fo�ation:
Contractor: �- � ��y��,. . ��t--�'�Contact Person: ��i��S I�.��r���-v
Address: `"���f J nn(t�.l�cc�ti�� C�'�Jc� State License #: �`7�� � �Z�1
City: �� - v1�i�cs.t Zip:�S 31v Expiration Date:
Phone: �f�3�y�, ? -,�.,:�.�71 Alternate Phone:
WATE�METF.�:PE1�II"�'�'�S ;^
- �LL BE CATJLUL�T�D BX CiT'Y fiTA� -'�--`. ,
❑ 5/8"METER- ❑ 3/4"METER- ❑ 1"METER-
❑ 5/8"HORN - ❑ 3/4"HORN - ❑ 1"HORN -
� "WATER METER (THESE WILL HAVE TO BE SPECIAL ORDERED&PRICES DETERMINED)
1. METER FEE: $
2. HORN FEE $
3. TOTAL PERMIT FEE(Add Lines 1-2 Above) $
CITY-USE ONLY
* For Current Pricing Refer to Current Year- Water Meter Pricing Chart *
BRAND: ED2F11 RDG3 �c
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SIZE: ❑5/8" ❑ 3/4" ❑ 1" ❑Other " 53975097
SERIAL#: iuumiiinniii46042 IIIIIII II I I IIIIIIII II I IIIIIIIIIIII
15459
ERT HIGH#: ui u iii ii mii n m i ui m ii (if applicable)
1545946042
AD�iTIONAL INFOi�MATION—�ATER I�ETERS
The undersigned hereby applies to the City of Orono for issuance of a water meter permit, agrees
to do all work in strict accordance with the ordinances of the City and the regulations of the State
of Minnesota, and certifies that all statements made on this application are,true and correct.
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Appli ant: � �'7�--- Date: �-�� `� �
Original: 1-Address File
Make Copies For: 1- Utility Billing Department
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