HomeMy WebLinkAbout2017-01618 - water meter s •�
CITY OF ORONO * 2 0 1 7 — 0 1 6 1 8 *
2750 KELLEY PARKWAY DATE ISSUED: 12/1U2017
ORONO,MN 55356-
(952)249-4600 FAX: (952)249-4616
ADDRESS : 3223 SHADYWOOD CIR
PIN : 20-117-23-11-0044
LEGAL DESC : SHADYWOOD VILLAS
: LOT 3 BLOCK 1
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"WATER METER
SERIAL 54008426
ERT# 1546108562 '
WATER METER RESIDENTIAL HORN 1 WATER METER RESIDENTIAL 1
APPLICANT WATER METER RESIDENTIAL 372.06
KRG PLUMBING INC WATER METER RESIDENTIAL HORN 144.64
1168 IFFERT AVE SE TOTAL 516.70
BUFFALO,MN 55313- Payment(s)
(612)282-5041 CREDIT CARD 6188 516.70
Minnesota State License#:plbg-PC644046
OWNER
Casco Ventures LLC
16192 STATE HWY NO 7
MINNETONKA,MN 55345-
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 Buildin�Code. 1'his permit is for only the work described and dces
not grant permission for additional or related work which requires separate
permiu. All provisions of laws and ordinances goveming this type of work
shall be compied with whether or not specified hercin.'fhis 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 requ'ved inspections are
requested in conformance with the State Building Code.1'his permit may be
revoked at any time for due cause.
�"� ` ��r�l l/�
Applic rm e Signature Date Issued B ignature Date
. , �
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City of Orono `
�� P.O.Box 66 � Pir�it�
O 2750 Kelley Parkway
crysra�sgy,MN 55323 A�p�ea�d�:(lf�: �._._, \
(952)249-4600 � /v
���q �.�� CITY OF ORONO-WATER METER FORM
kFSH�4 (Note:Some permits may require apprmal by the Building Official and/or Public Waks Deparmxnt)
C#��E�TE�?.1�L IIdFO�I�4�TIO�I
1. WATER METERS must be picked up and paid for at City Hall.
2. If possible,fax in this application ahead of tune;we will then call you and let you laiow 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.
_ . . _
''i Y�(�P�:�`
�C All'1"�
(�Residential(May Require Approval) ❑Commercial(Approval Required)
�
� New Meter ❑Addirional Meter—For: ❑Replacement Meter
3� S�e/O� �ttit�:
Site Address: _ ��-3 S�a t���ti C:�ul`
Owner: C'.��� C�� Go Mailing Address: /�Cs�v c�3c�a A�vt
City: �P`�'I�� Zip: ��`�y�
Home Phone: �r2-3�- ��3� Alternate Phone:
Co�a.��..
Contractor: �R(o P��t--r���^� �� Contact Person: ►_ �� �+•�syv
Address: l��$��- �� Sc> State License#: �C G4`I o�-1 b
City: ��� Zip:�3 Expiration Date: tZ-�t-��
Phone: C��L T-Bz-so L� � Alternate Phone:
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"y. '�k�fs�.r n+k h -Y" �
❑ 5/8"METER- ❑ 3/4"METER- � 1"MET'ER-
❑ 5/8"HORN - ❑ 3/4"HORN - 1"HORN -
� "WATER METER (THESE WII.L HAVE 7'O BE SPECIAL ORDERED&PRICES DETERMIlNED)
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*
ED2F11 RDG3 �c
BRAND: i.. t�d
„ 54008426 IIIIIIIII
SIZE: ❑5/8" ❑3/4" ❑ 1" ❑Other IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII
SERIAL#:
iii iuni uniu n ii un ui ii
ERT HIGH#: (if applicable) 1546108562
iuii�uuwuinNnmm�
7546108562
AD�iT��d,AL iNFO'I�A'T'It�'N—R�ATEA I�E'TEI+�S
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.
Applicant: Date: l2-�//7
Original: 1-Address File
Make Copies For: 1- Utility Billing Department