HomeMy WebLinkAbout2017-00481 - water meter CITY OF ORONO 1 1 11 1 Iii 11 II 11 111111 I II II
* 20 1 7 - 00 4 8 1
.. 2750 KELLEY PARKWAY DATE ISSUED: 05/12/2017
k • ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2380 SHADYWOOD RD
PIN : 17-117-23-44-0011
LEGAL DESC : WILEYS NAVARRE ADDN LAKE MTKA
: LOT MB BLOCK MB
PERMIT TYPE : WATER METER-COMMERCIAL/INDUSTIRAL
PROPERTY TYPE : COMMERCIAL-BUSINESS
CONSTRUCTION TYPE : WATER METER-COMMERCIAL/INDUSTRIAL
NOTE: 2 REPLACEMENT 1"WATER METERS: (METERS HAD GOTTEN FROZEN)
ERT: 1545526008
SERIAL: 53944766
ERT: 1545498984
SERIAL: 53944765
WATER METER COMMERCIAL 2
APPLICANT WATER METER COMMERCIAL 744.12
CITY VIEW PLUMBING&HEATING TOTAL 744.12
Payment(s)
1880-B WAYZATA BLVD W CHECK 37034 744.12
P.O. BOX 150
LONG LAKE,MN 55356
(952)473-8793
Minnesota State License#:plbg-MB005208
OWNER
PAUL AGRE COMPANY
811 W.CO RD F
SHOREVIEW,MN 55126-
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
c $.1
.ended for a period of 180 days at any time after work has commenced.
The app ant is responsible for assuring all required inspections are
requested i onformance ••ith . e State B ' :' g Code.This permit may be
‘ revoked at an ime for d - cause.
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A:plicant P'itee Signature Date Issued By Signature Date
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FOR CITY USE ONLY
O�T City of Orono � / Z -�� ✓
WP.O.Box 66 Date Received: J/l`1 1P mit# yg!
2750 Kelley Parkway
Crystal Bay,MN 55323 Approved By:(If Required):
(92)249-4600
o4Z CITY OF ORONO—WATER METER FORM
S H (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)
❑ Residential(May Require Approval) ❑ Comrngfcial(Approval Required)
D New Meter ❑Additional Meter—For: Replacement Me. ,4,.,ter
Job Site/Owner Information: ia7,
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Site Address: g.350 SaG aGIS �g,,,,id,in
Owner:1272Z�1PiVai, p fling Address: Z ;n
City: ff Zi R1
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7 Home Phone: q9--).- 34-- (15TAlternate Phone: m,? J
Contractor Information:
Contractor: C! UI ec.J 0) 1i5 ntact er n: Ott.,/ "/� , W�
Address: !1-' tate License #: +5 J p 7 6 3
City: Lerr Cake Zip: Expiration Date:
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Phone: Alternate Phone:
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WA MR1VIETER:PERMIT
WILL BE.CAULULATED BY CITY STAFF -r". ''' ,Afv,__,_
❑ 5/8"METER- ❑ 3/4"METER- 1METER-
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❑ 5/8"HORN - ❑ 3/4"HORN - 1"HORN -
❑ "WATER METER (THESE WILL HAVE TO BE SPECIAL ORDERED&PRICES DETERMINED)
1. METER FEE: $
2. HORN FEE $
3. TOTAL PERMIT FEE(Add Lines 1-2 Above) $ J - ,
IL -11 II
CITY-USE ONLY ED2F1IRDG3 tii. J
1- +?
* For Current Pricing Refer to Current Year- Water Meter Pr 53944766
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-t)- �.•_�k 11111111311111111111111111111111111113BRAND:
SIZE: 0 5/8" 0 3/4" 1" 0 Other .,_.a
3II III II IIII III III III III III
SERIAL#: 154552600E
ERT HIGH}#: (if applicable)
ADDITIONAL INFORMATION-WATER METERS
The undersigned hereby applies to the City of Orono for issuance of a water nieter permit, agrees
,'t6 10 al . , in strict accordance with the ordinances of the City and the,regulations of the State
of Min esota, a'd certifi that all statements made on this application are,true and correct.
Ir\i ").-\
Date: �
Applicant. 0 7
ED2F11RDG3
53944765 11111111
CITY VIEW
1111111111111111111111
Plumbing& Heating, Inc.
1880-B West Wayzata Blvd. • P.O. Box 150
Long Lake, MN 55356
(952)473-8793 FAX: (952)473-7812 ,
www.CityViewPlumbing.com 411111111111111111111111111
1545498984
Original: 1-Address File
Make Copies For: 1- Utility Billing Department