HomeMy WebLinkAbout2014-00885 - water meter ,�� CITY OF ORONO * 2 0 1 4 - 0��
� 2750 KELLEY PARKWAY DATE ISSUED: 08/18/2014
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2524 SANDSTONE LA
PIN : 33-118-23-11-0019
LEGAL DESC : STONEBAY
: LOT 016 BLOCK 001
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)249-4613
5/8" METER
SERIAL#94096357
ERT HIGH# 1850445045
WATER METER RESIDENTIAL HORN 1 WATER METER RESIDENTIAL 1
APPLICANT WATER METER RESIDENTIAL 245.70
WATER METER RESIDENTIAL HORN 68.97
SCHULTIES PLUMBING TOTAL 314.67
1521 94TH LANE NE
BLAINE, MN 55449 Payment(s)
(651)786-4007 CHECK 33023 314.67
Minnesota State License#: plbg-058799PM,mech-MB005379
OWNER
Stonebrook Homes
1016 COVETRY PL
EDINA,MN 55424-
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
no[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 180 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 aze
requested in conformance with the State Building Code.This permit may be
revoked at time for ue cause.
� ���r� �' / /� /l
Applican e itee Signature Date Iss By Signature Date
F R C Y USE ONLY
{� City of Orono � �
rO�O P.O.Box 66 Date Receive :� Permit# � �
2750 Kelley Parkway
Crystal Bay,MN 55323 Approved By(If Required):
(952)249-4600
�F �
�qkEs�{p���' CITY OF ORONO—WATER METER FORM
(*Note:Some permits may require approval by the Building Official and/or Public Works Department
+�
GENERAL INFORMATION
1. WATER METERS must be picked up and paid for at City Hall.
2. If possible,fax 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.
TYPE OF PERMIT
Check All That A 1
�]Residential (May Require Approval) ❑ Commercial(Approval Required)
�New Meter ❑Additional Meter—For: ❑ Replacement Meter
Job Site/Owner Information:
Site Address: vr��'
Owner: �.c�r' �_""�� 1� �� � �
�-� �ilingAddress: �l/ ,��I ��� �e
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City: � Zip: `�'�•��
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Home Phone: ��-':'�J—d��� Alternate Phone: �D%����j���
Contractor Information:
Contractor: ,��i ,�,c,�.f�",�r.�,�!,,,,�� � Contact Person: � ,
Address: ��� ��� State License #: � /�j��j
City: ���1.-r�.t� Zip� Expiration Date: �✓�j �1
Phone: J�.,7—j.�—���J� Alternate Phone: ���` '—�a���
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WATER METER PERMIT FEES
WILL BE CAULULATED BY CITY STAFF
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) $ d � ` �/
CITY-USE ONLY
* For Current Pricing Refer to Current Year- Water Meter Pricing Chart *
BRAND: 1 v� � v�� �
SIZE: �,5/8" ❑3/4" ❑ 1" ❑Other "
SERIAL#:
� 9`�a �' lP3 5 7
ERT HIGH#: III III IIII I IIII II III I II II IIII
1850445045 (if applicable)
ADDITIONAL iNFORMATION—WATER METERS
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.
Applic � Date: � ij ���
Original: 1-Address File
Make Copies For: 1- Utiliry Billing Department 1-Cash Drawer