HomeMy WebLinkAbout2009-00011 - water meter � �
CITY OF ORONO PERMIT NO.: 200�-000�1
2750 KELLEY PARKWAY
ORONO,MN 55356- DATE ISSUED: OUi3/2009
952 249-4600 FAX: 952 249-4616
ADDRESS : 3915 SHORELINE DR
PIN : 20-117-23-22-0005
LEGAL DESC : TOWNSITE OF LANGDON PARK
: LOT 001 BLOCK 008
PERMIT TYPE : PL�'i(<�6j �/�}7�rY�}:-r�IZ
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER METER
NOTE: METER WAS FROZEN AND HOMEOWNER NEEDED TO PURCHASE NEW METER.
NEPTUNE 5/8"WATER METER REPLACEMENT
SERIAL#86055584
ERT HIGH#1820824903
WATER METER RESIDENTIAL HORN 1 WATER METER RESIDENTIAL 1
APPLICANT WATER METER RESIDENTIAL 259.40
KRUGER,KONRAD WATER METER RESIDENTIAL HORN 52.00
3915 SHORELINE DR
SPRING PARK,MN 55384 TOTAL 311.40
OWNER
KRUGER,KONRAD
3915 SHORELINE DR
SPRING PARK,MN 55384
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 sepazate
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 nuil 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
req ested in conformance with the Stat � ing Code.This permit may be
re ked at any time fo due cause.
� ���� �/ �/3 �D
Applicant Perm�e Signature Date Iss e y Sign re Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
�
Q,� �O City of Orono ������� ' /�/%
� P.O.Box 66 UStC R�ceiv�� � ' Pemtit#����„ C/C/�/
2750 Kelley Pazkway
�ii r� Crystal Bay,MN 55323 AppmYed By:(IPRequit`ed):
(952)249-4600
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CITY OF ORONO—WATER METER FORM
(*Note:Some permits may require approval by the Building Official and/or Public Works Departrnent*)
GEl�]ERAL INFORMATIQN
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 lrnow 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.
' TYFE�F PERMFT
Cheek Al1 That A 1
❑Residential(May Require Approval) ❑Commercial(Approval Required)
❑New Meter �Additional Meter—For: �Replacement Meter
Job Site/Uwner Information:
Site Address: � I l � J�d r��YIC� �r 1 V e,
Owner: Q� q� Mailing Address:
_ J
c��: ��.(' z�p: 5J��
Home Phone: Alternate Phone:
Contractar Infarmation:
Contractor: Contact Person:
Address: State License#:
City: Zip: Expiration Date:
Phone: Alternate Phone:
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I���r �.s
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WATER METER PERMIT FEES
WILL BE CAULULATED BY CITY ST�FF
/8"METER- ❑ 3/4"METER- � 1"METER-
5/8"HORN - ❑ 3/4"HORN - ❑ 1"HORN -
❑ "WATER METER (THESE W[LL HAVE TO BE SPECIAL ORDERED&PR[CES DETERMINED)
l. METER FEE: $ p �g� (�
2. HORN FEE $ �O �
3. TOTAL PERMIT FEE(Add Lines 1-2 Above) $ �L��
CITY-USE ONLY
* For Current Pricing Refer to Current Year- Water Meter Pricing Chart *
BRAND: I Y � �'�
SIZE: �5/8" ❑ 3/4" ❑ 1" ❑Other "
SERIAL#: � (�� �j j ��
ERT HIGH#: IIIIIIIIIIIIIIIIIIIIIIIIIIIII
1820824903 (if applicable)
ADDITIONAL 1NFORMATION—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.
Applicant: ��' Date:
Reset Form
Original: 1-Address File
Make Copies For: 1- Utility Billing Department 1-Cash Drawer