HomeMy WebLinkAbout2010-00206 - water meter . ^� CITY OF ORONO PERMIT NO.: 2oiaoo2o6
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUED: 04/13/2010
952 249-4600 FAX: 952 249-4616
ADDRESS : 2105 SUGARWOOD DR
PIN : 34-118-23-21-0017
LEGAL DESC : SUGAR WOODS
: LOT 003 BLOCK 003
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
NEPTiJNE 3/4"METER-SERIAL#51547259 ERT 1820504364
WATER METER RESIDENTIAL HORN 1 WATER METER RESIDENTIAL 1
APPLICANT WATER METER RESIDENTIAL 322.20
B&D PLUMBING&HEATING INC. WATER METER RESIDENTIAL HORN 86.64
4145 MACKENZIE CONST TOTAL 408.84
MN 55376-
(763)497-2290
OWNER
SMITH,THOMAS&VIRGINIA
2105 SUGARWOOD DR
LONG LAKE,MN 55356-
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 separate
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 consWction 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 confortnance with the State Building Code.This permit may be
revok t any time for due cause.
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/ / / /
icant Permitee Signature Date Issued By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
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FOR CI US�ONLY
0 City of Orono 1f /�,
4$` �O P.O.Box 66 Date Received:/9 � Permit# �l�' ���"'
2750 Kelley Pazkway
Crystal Bay,MN 55323 Approved By:(If Required):
���� (952)249�600 � �
CITY OF ORONO—WATER METER FORM � D8��
(*Note:Some permits may require appmval by the Building Official and/or Public Wo►ics Department•) �
GENERAL INFORMATION
1. WATER METERS must be picked up and paid for at City Hall.
2. If nossible,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 ❑Additional Meter—For: �Replacement Meter
Job Site/Owner Information:
Site Address: 2105 Sugarwood Drive
Owner: Mailing Address:
City: Zip:
Home Phone: Alternate Phone:
Contractor Tnformation:
Contractor: B&D Plumbing/Ht. &A.C. Contact Person: �oe Barbeln
Address: 4145 MacKenzie Court N.E. State License#: 5928�
St. Michael, MN 55376 12/31/2010
City: Zip: Expiration Date:
(763)497-2290 (612)328-0324
Phone: Alternate Phone:
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❑ 5/8"METER- Q 3/4"METER- 0 1"METER-
❑ 5/8"HORN - Q 3/4"HORN - ❑ 1"HORN -
� "WATER METER (THESE WILL HAVE TO BE SPECIAL ORDERED&PRICES DETERMINED)
1. MET'ER 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: �
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SIZE: ❑5/8" �%4" ❑ 1" ❑Other "
SE�.#: �ti�- �i � � ��s 9
ERT HIGH#: ����������������������������� (if applicable)
1820817364
ADDITIONAL INFORMATION—WATER METERS
T'he 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.
04/08/2010
Applicant: Date:
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Original: 1-Address File
Make Copies For: 1- Utility Billing Department 1-Cash Drawer