HomeMy WebLinkAbout2010-00153 - water meter CITY OF ORONO PERMIT NO.: 2010-00153
2750 KELLEY PARKWAY
� ORONO, MN 55356- DATE ISSUED: 03/17/2010
952 249-4600 FAX: 952 249-4616
ADDRESS : 743 BRIDGEWATER DR
PIN : 33-118-23-11-0107
LEGAL DESC : STONEBAY FOURTH ADDITION
: LOT 001 BLOCK 001
PERMIT TYPE : WATER METER
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER METER
NOTE: INSEPCTIONS ARE DONE BY PUBLIC WORKS DEPARTMENT.
TO SET-UP AN[NSPECTION,PLEASE CALL:(952)249-4613
5/8" NEPTUNE METER-SERIAL#88930�92 -ERT HIGH 1830723141
WATER METER RESIDENTIAL HORN 1 WATER METER RESIDENTIAL 1
APPLICANT WATER METER RESIDENTIAL 268.05
PLUMB RIGHT WATER METER RESIDENTIAL HORN 66.83
1216 82ND AVE N
BROOKLYN PARK, MN 55444 MISC FEE 0.00
(763)561-3306 TOTAL 334.88
OWNER
O.T. Development,LLC
2670 KELLEY PKWY
ORONO, MN 55356-
AGREEMENT AND SWORN STATEMENT
'rhe 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 wi[h whether or not specified herein.This permit will
expire and becomc 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 l80 days at any time afrer work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revo y time or due c
��/�//c�/� � � l l
Applicant Permitee Signature Date Issued By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
r
FOR C1TY USE ONLY
�Q� City Of�COI10 3��
P.O.Box 66 Date Receivedf/ Permit#�l� � d I��
��;;,,,,, � 2750 Kelley Parkway
a t�''�;<<: � Crystal Bay,MN 55323 Approved By:(If Required):
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�^����r$�o` (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 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 lcnow 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 Apply)
�Residential(May Require Approval) ❑ Commercial(Approval Required)
❑ New Meter ❑ Additional Meter—For: � ❑ Replacement Meter
Job Site / Owner Information:
Site Address: i'y3 ,��,�./,�.z-�N
�
Owner: � � Mailing Address:
City: Zip:
Home Phone: Alternate Phone:
Contractar Information:
Contractor: ,f' Contact Person: �� �
Address: /���-���„����/ State License#: d.S��7,j y ���
City: (�� � �, Zip:S��� � �Expiration Date: �� 3� �b
Phone: ��,5��/.s,3�'Gy Alternate Phone:
i ,
WATER METER PERMIT FEES
WILL BE CAULULATED BY CITY STAFF
� 5/8"METER- ❑ 3/4"METER- ❑ 1"METER-
5/8"HORN - ❑ 3/4"HORN - ❑ 1"HORN -
❑ "WATER METER (THESE WILL HAVE TO BE SPECIAL ORDERED 8 PRICES DETERMINED)
1. METER 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: ���G(_,vI�
SIZE: �5/8" ❑ 3/4" ❑ 1" ❑ Other "
sE�AL#: g 8930�9�.
ERT HIGH#: ����������������������������� (if applicable)
1830723141
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.
Applican . �"� � Date: � �7
Original: 1-Address File
Make Copies For: 1- Utility Billing Department 1-Cash Drawe�-