HomeMy WebLinkAbout2008-00189 - water meter + �
_ i
CITY OF ORONO PERMIT NO.: 200�-oo�g9
2750 KELLEY PARKWAY
ORONO,MN 55356- DATE IssuEn: 09/03/2008
952 249-4600 FAX: 952 249-4616
ADDRESS : 2264 SHADYWOOD RD
PIN : 17-117-23-43-0124
LEGAL DESC : WILEYS PARK LAKE MTKA
: LOT 005 BLOCK 001
PERMIT TYPE : WATER METER
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER METER
NOTE: INSEPCTIONS ARE DONE BY PUBLIC WORKS DEPARTMENT.
TO SET-UP AN INSPECTION,PLEASE CALL:(952)249-4613
NEPTUNE 3/4"WATER METER-SERIAL#51051606-ERT HIGH-1810250492
WATER METER RESIDENTIAL HORN 1 WATER METER RESIDENTIAL 1
APPLICANT WATER METER RESIDENTIAL 312.40
MR.ROOTER PLUMBING WATER METER RESIDENTIAL HORN 61.00
5155 E.RIVER ROAD TOTAL 373.40
FRIDLEY,MN 55421-
�)
Minnesota State License#: 58659PM
OWNER
ZIEGLER,THOMAS
2264 SHADYWOOD 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 Ciry approvals,and the
State Building Code. This pem►it is for only the work described and does
not grant permission for additional or related work which requires sepazate
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 c fo ce with the State Building Code.This permit may be
revoked at y i ;for e c s .
� l � Ir/d � Iv Iv D
Appl' Permitee ign re Date Is By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
1 �
.
�
FOR CITY USE:ONLY
v O,¢��O City of Orono j ' /� �
P.O.Box 66 Date Received: £�'����ermit#6r�
2750 Kelley Parkway
� � ;.v� Crystal Bay,MN 55323 Approved By:(IfRequired):
�_ ` sy (952)249-4600
�atsxo
CITY OF ORONO—WATER METER FORM
(*Note:Some permits may require approval by the Building Official and/or Public Works Deparhnent*)
GENER.AL 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 ❑Addirional Meter—For: �Replacement Meter
rob Site/Owner Information: :
Site Address: Z�v � p/
Own� Mailing Address:
City: Zip:
Home Phone: Alternate-PYi'on`���/� `����//
Contractor Inforrnation:
Contractor;�t Contact Person:
Address: �� r � � State License#: �J,��1��3���
City: i�� Expiration Date: _ � �.
,�,�T d
Phone: Alterna�e�`�one: ��
�
, , ►
,
.
�
❑ 5/8"METER- [�] 3/4"METER- ❑ 1"METER-
❑ 5/8"HORN - [� 3/4"HORN - ❑ 1"HORN -
❑ "WATER METER (THESE WILL fIAVE 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: '�.� Vl�_
SIZE: ❑ 5/8" �'37'4" ❑ 1" ❑ Other " � � �J
SERIAL#: 5�O �I �,O C� �p
ERT HIGH#: �c ��t��W���� (if applicable)
ADI�TTTONAL INFORMATTQN:—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 certifie hat all statements made on this application are,true and correct.
Applicant: Date:
Original.• 1-Address File
Make Copies For: 1- Utiliry Billing Department 1- Cash Drawer