HomeMy WebLinkAbout2009-00745 - water meter � � CITY OF ORONO PERMIT NO.: 2009-00745
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUEn: 10/22/2009
952 249-4600 FAX: 952 249-4616
ADDRESS : 3480 SHORELINE DR
PIN : 17-117-23-43-0093
LEGAL DESC : NAVARRE HEIGHTS
: LOT 017 BLOCK 006
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
REPLACEING 5/8"WATER METER-NO HORNS WERE NEEDED
WATER METER RESIDENTIAL 1
APPLICANT WATER METER RESIDENTIAL 268.05
SCOTT, LYLE&JOYCE TOTAL 268.05
2508 BANTAS POINT LA
MINNETONKA, MN 55391 PAID WITH CC# 8645
OWNER
SCOTT, LYLE&JOYCE
2508 BANTAS POINT LA
MINNETONKA, 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 separa[e
permits. All provisions of laws and ordinances governing 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 wi�e State Building Code.This permit may be
revoked at ap�ti�for due caus� �
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�Appli��n�Permitee Signat e Date ' Iss y Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
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FOR CITY USE ONLY
,�p�, City of Orono �
P.O.Box 66 Date Received: Permit#
��:;„ �� 2750 Kelley Parkway
� ����f� �*( Crystal Bay,MN 55323 Approved By:� Amount$:
�� ��� �c` ' (952)249-4600 � �
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CITY OF ORONO—PLUMBING PERMIT
(All Commercial permits must be approved by the Buildine Official or Inspector)
GENERAL INFORMATION
1. You may apply for plumbing permits by mail or in person at the City offices. Applications will be
reviewed and a permit will be issued within two working days.
2. Permit cards will be sent by return mail after a review is completed. PERMITS ARE NOT
VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE
PERMIT CARD IS POSTED ON THE JOB SITE.
3. Plumbing perrruts may be issued ONLY to licensed plumbing contractors and to property owners
residing in the dwelling.
4. When any new construction or remodeling is involved, a separate building permit must be
obtained.
5. All work must be done in accordance with State Code requirements.
6. All work must be inspected and air tested before it is covered. Call(952) 249-4600.
(24-48 hour notice required)
TYPE OF PERMIT
(Check All That Apply)
�Residential ❑ Commercial(Approval Required)
❑ New ❑Additional ❑Repairs ❑ Replace
� ❑ In Accessory Structure?
*You will need arior appro��al and may need CUP.(Per Orono City Code, Chapter 78,Article IV)
Job Site / Owner Information:
Sife Address:j�/��3 �� ���� � „����
Owner:�>��> � Mailing Address:
city: �LI�'�-�.�if' zip: 55 3 �7
Home Phone: �/`� �i� �/���D Alternate Phone:
Contractor Information:
Contractor: Contact Person:
Address: State Bond #:
City: Zip: Expiration Date:
Phone: Alternate Phone:
❑ Insurance— Current:
1
Y '
FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 2 OTHER
TYPE FL FL TYPE FL FL
Water Closet Floor Drains
Lavatory Sewer Ejector
Bathtub Laundry Tray
Shower Washer
Kitchen Sink Water Heater
Disposal Water Softener
Dishwasher Wet Bar
Sillcocks Miscellaneous
❑ Yes,this section applies
The replacement of a Residential fixture or appliance that meets all three of the following requirements:
1. Does not require modificarion to electrical or gas service.
2. Has a total cost of$500.00 or less;excludine the cost of the fixture or appliance:and
3. Is improved,installed or replaced by the homeowner or licensed contractor.
Skip next secrion,if this applies; Cost of Perxnit $ 15.00
State Surcharge $ .50
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee $
(Permit Fees Continued On Neat Page)
2
ti a
CIT USE ONLY
p�` City of Orono
O4 `�'O P.O.Box 66 Date Receiv : � Permit#��� O�
" 2750 Kelley Parkway
� ? ,-..� Crystal Bay,MN 55323 Approved By:(If Required):
��o$y (952)249-4600
CITY OF ORONO—WATER METER FORM
(*Note:Some permits may require approval by the Building Official and/or Public Works Department*)
GENERAL INFORMATTON
1. WATER METERS must be picked up and paid for at City Hall.
2. If possible,fax in this applicarion 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 wam 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�F PERMIT ',
(Check A11 Tl�at A 1
❑Residential(May Require Approval) ❑ Commercial(Approval Required)
�Tew Meter ❑Additional Meter—For: ❑Replacement Meter
�
'Job Site/Owner Information:
Site Address: � �"D CJ <<�� � �
Owne • ���� Mailing Address:
CitY� Zip� � SJ� �
Home Phone: ��7.Tl�o� Alternate Phone:
Contractor Information:
Contractor: Contact Person:
Address: State License#:
City: Zip: Expiration Date:
Phone: Alternate Phone:
� r
�� � 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: $ �C�� O �
2. HORN FEE $
3. TOTAL PERMIT FEE (Add Lines 1-2 Above) $ O�.�Q �.� �
CITY-USE ONLY
* For Current Pricing Refer to Current Year- Water Meter Pricing Chart *
BRAND: / v-�jJ ��/G��
SIZE: �] 5/8" ❑ 314" ❑ 1" ❑ Other "
SERIAL#: � ���D��7�
ERT HIGH#: ����������������������������� (if applicable)
1830279097
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 ardinances 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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Applicant: � � �� �' Date•l-�� �f; �l� j�
Original: 1-Address File
Make Copies For: 1- Utiliry Billing Department 1- Cash Drawer