HomeMy WebLinkAbout2017-00032 - residential water meter CITY OF ORONO * 2 0 1 7 - 0 0 0 3 z *
2750 KELLEY PARKWAY DATE ISSUED: OU13/2017
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 3382 SHORELINE DR
PIN ' : 17-117-23-44-0100
LE`GAL DESC : TOWNSITE OF LANGDON PARK
: LOT 005 BLOCK 003
PERMIT TYPE : WATER METER-RESIDENTIAL
PROPERTY TYPE : COMMERCIAL- BUSINESS
CONSTRUCTION TYPE : WATER METER-RESIDENTIAL
NOTE: INSEPCTIONS ARE DONE BY PUBLIC WORKS DEPARTMENT.
TO SET-UP AN INSPECTION,PLEASE CALL:(952)249-4613
ACTUALLY THIS WILL BE INSTALLED AT 3380 SHORELINE DRIVE
SERIAL#1542769602
ERT 53713915
WATER METER RESIDENTIAL HORN 1 WATER METER RESIDENTIAL 1
APPLICANT WATER METER RESIDENTIAL 372.06
WATER METER RESIDENTIAL HORN 144.64
KRAHL'S PLUMB LLC TOTAL 516.70
3508 LYRIC AVE Payment(s)
WAYZATA, MN 55391- CREDIT CARD 0374 516.70
(612)730-9988 5
Minnesota State License#: plbg-PC653470
OWNER
Narrows LLC
PO BOX 36
NAVARRE, MN 55392-
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 Buiiding 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 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 alI required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due caus�:'
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Applicant Permitee�i ature,�� �. � Date [ssued By Signature Date
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F`OR CTfY USE QNLY
,�O A T City of Orono
1 V P.O.Box 66 Date Rccsived:. ,��J.3"r Pe�nit# �-�C% 7-G �.'�<'
� 2750 Kelley Pazkway
� Crystal Bay,MN 55323 Agproved By:(If Required): `..��'
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`q'F�SH���G CITY OF ORONO—WATER METER FORM
(Note:Some permits may require approval by the Building Official and/or Public Works Department)
GENERAL INFORMATIOI�1
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)249-46]6. 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(JF PERIV�IT
Check All That A 1
❑ Residential(May Require Approval) ❑Commercial(Approval Required)
❑ New Meter ❑Additional Meter—For: ❑ Replacement Meter
Job Site/Owner Information:
�j� Site Address: �����(9i'g' /� /V�L�LJ� �nU�
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Owner: Mailing Address:
City: Zip:
Home Phone: Alternate Phone:
Confiractor Informatian:
Contractor: �`�7 l ���i�,- Contact Person: ����� �!��j�
Address: ��/� ���C State License#:
City: �' � 't� Zip: 3�� Expiration Date:
Phone: ���� �3�`'��� Alternate Phone: �`� '` �� (��- ��g�
WATER METER PERMIT FEES
VVILL 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)
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$ ,� � ,.,�^ , (,�'C-•.
1. METER FEE:
$ r � �;t/
2. HORN FEE
3. TOTAL PERMIT FEE(Add Lines 1-2 Above)
$ �� `�G�
CITY-USE ONLY
* For Current Pricing Refer to Current Year- Water Meter Pricing Chart *
BRAND: , ED2F11 RDG3 �
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SIZE: ❑ 5/8" ❑3/4" �] 1" ❑Other 53713915
SERIAL#: � JJ` =� Illillll�'llliilillllllllllllllllllllllllllllllllll
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ERT HIGH#: � iinnnuiuuuni����ui�i (if applicable)
1542769602
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 accordanc with the ordinances of the City and the regulations of the State
of Minnesota, and certifies tha all ate ents made on this application are,true and correct.
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Apphcant: Date: 1
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Original: 1-Address File
Make Copies For: 1- Utility Billing Department