HomeMy WebLinkAbout2018-00265 - water meter 1111101 111101M
* . + CITY OF ORONO * 2018 - 0026S *
2750 KELLEY PARKWAY DATE ISSUED: 03/09/2018
ORONO,MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS 3670 TOGO RD
PIN 17-117-23-31-0032
LEGAL DESC TOWNSITE OF LANGDON PARK
LOT 004 BLOCK 010
PERMIT TYPE WATER METER-RESIDENTIAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER METER-RESIDENTIAL
NOTE: 1NSEPCTIONS ARE DONE BY PUBLIC WORKS DEPARTMENT.
TO SET-UP AN INSPECTION,PLEASE CALL:(952)249-4600
5/8"WATER METER
SERIAL 36789181
ERT 1548081610
WATER METER RESIDENTIAL HORN 1 WATER METER RESIDENTIAL 1
APPLICANT WATER METER RESIDENTIAL 253.00
WATER METER RESIDENTIAL HORN 82.02
ZAPPA,MICHAEL&LORI TOTAL 335.02
19622 CO RD 35 Payment(s)
ELK RIVER,MN 55330- CREDIT CARD 1956 335.02
OWNER
ZAPPA,MICHAEL&LORI
19622 CO RD 35
ELK RIVER,MN 55330-
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 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 are
requested in conformagoe'qh the State Building Code.This permit may be
revo 'd at any ti or du cause.
Applicant Permitee Sip
r Date Issued By Signature Date
r, �rt,yA t gg
018'
TER- ❑ 3/4"METER- ❑ 1"METER-
HORN - ❑ 3/4"HORN - ❑ 1"HORN -
❑ "WATER METER MIESE WILL HAVE TO BE SPECIAL ORDERED&PRICES DETERMINED)
1. METER FEE: $ '9S 3-D0
2. HORN FEE $ - a'0-P--
3.
--3. TOTAL PERMIT FEE(Add Lines 1-2 Above) $ D
CITY-USE ONLY
* For Current Pricing Refer to Current Year- Water Meter Pricing Chart
ED21311 RDG3
BRAND: W8"x 314"
36789181 IIIII IIII Ilii
SME; rls- ❑3/4" ❑ 1" ❑other ° IIBIIIIIiIiiIIIIIIIN �IINNI
SERIAL#:
applicable) ininmm�miiiinnum
ERT HIGH#: (if app ) 1548081610
ADDMNAL ON—WATER MET'EM
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:
Original: I-Address File
Make Copies For: 1- Utility Billing Department
City of Orono
P.O.Box 66 1 R�IpesiVai;t�
Q 2750 Kelley Parkway
Crystal Bay,MN 55323 AppwW Illy:(If
(952)249-4600
o4``G CITY OF ORONO—WATER METER FORM
SHO (Note:Some permits may require approval by the Building Official and/or Public Works Deparimem)
GENERAL WORMAnON
1. WATER METERS must be picked up and paid for at City Hall.
2. I_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 meter installation.
TYPE Off'PST`
All ThO
Residential(May Require Approval) ❑Commercial(Approval Required)
❑ New Meter ❑Additional Meter—For: Replacement Meter
Job Site/O 11> :
Site Addre s: ��� rC
Owner: Mailing Address:
City: Gt Zip: l� ivy lSS330
Home Phone: Alternate Phone:
Col ftwtor Dation:
Contractor: Contact Person:
Address: State License#:
City: Zip: Expiration Date:
Phone: Alternate Phone: