HomeMy WebLinkAbout2011 - 00161 - water meter CITY OF ORONO PERMIT NO.: 2011-00161
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2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUED: 03/17/2011
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2605 WEST LAFAYETTE RD
PIN : 21-117-23-21-0007
LEGAL DESC : SHORE HILLS
: LOT 000 BLOCK 000
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
WATER METER RESIDENTIAL HORN 1 WATER METER RESIDENTIAL I
APPLICANT
WATER METER RESIDENTIAL 392.92
BLANKENSHIP,BRADFORD&DEBORAH WATER METER RESIDENTIAL HORN 104.45
2605 WEST LAFAYETTE RD TOTAL 497.37
EXCELSIOR, MN 55331-
OWNER
BLANKENSHIP, BRADFORD& DEBORAH
2605 WEST LAFAYETTE RD
EXCELSIOR,MN 55331-
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 informance with the State Building Code.This permit may be
revs - i+. or due cause.
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SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBROVE.
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F RCI Y USE ONLY
City of Orono 3 V 1/—06. /W
O¢ 4. City
P.O.Box 66 Date Receive . / �( Permit
r,t,, 2750 Kelley Parkway
q4.t,,,- Crystal Bay,MN 55323 Approved By:(If Required):
V.i , c (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 INFORMATION
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)249-4616. 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 OF PERMIT
(Check All That Apply)
/21 Residential (May Require Approval) 0 Commercial(Approval Required)
pNew Meter fJ Additional Meter-For: ❑Replacement Meter
Job Site/Owner Information:
Site Address: � Z),_..71--- 4-3c-----?"- Z A- �-y 7-l' A
Owne41J ,-, V Mailing Address: ,0(.5-
City: -?(C. ---l_.....-4/.4,---
City: -?C' Z,�5,i 4,-- Zip: __:353/ ` 7:257.
Home Phone:9\L &10 34,2 Alternate Phone: C/ vs-7 33 K
Contractor Information:
Contractor: Contact Person:
Address: State License#:
City: Zip: Expiration Date:
Phone: Alternate Phone:
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WATER METER PERMIT FEES
WILL BE CAULULATED BY CITY STAFF
D 5/8"METER- ❑ 3/4"METER- S�II 'METER-
® 5/8"HORN - ❑ 3/4"HORN - 1"HORN -
"WATER METER (THESE WILL HAVE TO BE SPECIAL ORDERED&PRICES DETERMINED)
1. METER FEE: $ s �
2. HORN FEE $ 4• 1/.5
3. TOTAL PERMIT FEE(Add Lines 1-2 Above) $ ufAirA
If97, 37
CITY-USE ONLY
* For Current Pricing Refer to Current Year- Water Meter Pricing Chart *
BRAND: 11111111111111111111111111111 /`ki �.
1820458145
SIZE: ❑5/8" ❑ 3/4" 1" ❑Ot er "
SERIAL#: GI 51 90v6 ( O
ERT HIGH#: I U 3O (if applicable)
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 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.
I
Applicant: `� 'ief;7-e".V7
Date: t-//7/ (
Reset Form
Original: I-Address File
Make Copies For: I- Utility Billing Department 1-Cash Drawer
Barb Silus
From: Scott Oberaigner
Sent: Tuesday, October 26, 2010 2:48 PM
To: Rachel Dodge; Barb Silus; Monica Fadness; Lin Vee
Subject: 2605 West Lafayette fees for water hookup in 2010
Here are the water hookup fees for 2605 West Lafayette 1" meter and horn = $4-7-2-.-51-54.
4.-2, `'(9 7 37
Hookup charge = $2,820.00
Permit fee = $55.00
TOTAL=$3,347.51
Scott Oberaigner 3 - / 7-//
Utilities Supervisor /9er/Xle-ts ,SS- "46
2700 Kelley Parkway Ct
Orono, MN 55356
Main (952) 249-4600 C=Bc-1 t OrA
Office (952) 249-4680 q
Fax (952) 249-4616
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