HomeMy WebLinkAbout2010-00901 - water meter CITY OF ORONO PERMIT NO.: 2010-00901
2750 KELLEY PARKWAY
• > ORONO, MN 55356- �ATE ►SS[1�n: 09/27/2010
952 249-4600 FAX: 952 249-4616
ADDRESS : 745 BRIDGEWATER DR
PIN : 33-118-23-11-0108
LEGAL DESC : STONEBAY FOURTH ADDITION
: LOT 002 BLOCK 001
PERMIT TYPE : WATER METER
PROPERTY TYPE : RESIDENTiAL
CONSTRUCTION TYPE : WATER METER
NO'I'E: INSBPC"TIONS ARE DONE BY PUBLIC WORKS DEPARTMEN"C.
TO SET-UP AN INSPGCTION,YLEASE CALL: (952)249-4613
WATER METER RESIDENTIAL HORN 1 WATER METER RES[DENTIAL 1
APPLICANT WATER METER RESIDENTIAL 268.05
PLUMB RIGHT WATER METER RESIDENTIAL HORN 66.83
1216 82ND AVE N
BROOKLYN PARK, MN 55444- TOTAL 334.88
(763)561-3306
OWNER
O.T. Development, LLC
10300 l OTH AVE N
PLYMOUTH,MN 55441-
AGREEMENT AND SWORN STATEMENT
I�he 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 tor additional or related work which requires separate
permits. All provisions of laws and ordinances governing this type of work
shall be compicd with whether or not specified herein.This permit will
expirc and become null and void if construction authorized is not
commcnced within 180 days of the date of issuance,or if construction is
suspended for a period of l80 days at any time after work has commenced.
The appiicant is responsible for assuring all required inspections are
requcsted in contormance wi[h the State Building Code.This permit may be
revoked at any time for due cause.
/ / / /
Applieant Permitee Signature Date Issued 13y Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
' � FOR C1TY L'SE ONLY
O,�p�O City of Orono
P.O.Box 66 Date Received: Permit#
�;�,,�„� 2750 Kelley Parkway
� �'`'?�;�� F Crystal Bay,MN 55323 Approved By:(If Required):
������f��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. Ifpossible,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. VVATER METERS must be set and sealed by Orono VVater 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: � —
Owner: �G ��,�,� Mailing Address:
City: Zip:
Home Phone: Alternate Phone:
Contractor Information:
Contractor: � Contact Person:
Address: �z./��.�--�..,�1(� State License#: ���7.3j�� �%'I
City: � Zip:s>�f��Expiration Date: /L � ��
Phone: `��� -��3,3U� Alternate Phone: � 7l3��'�yj�'��'
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&PRICES DETERMINED)
L METER FEE: $ ��C�� �� �� S
2. HORN FEE $ CL? � , �� �
3. TOTAL PERMIT FEE(Add Lines 1-2 Above) $ � ��� ���
CITY-USE ONLY
* For Current Pricing Refer to Current Year- Water Meter Pricing Chart *
BRAND: �v � �� l � /'1.-SL.—.
SIZE: � 5/8" ❑ 3/4" ❑ 1" ❑ Other "
SERIAL#: � / � � �(� 9
ERT HIGH#: ��������������I����I��������� (if applicable)
1830857684
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 sh-ict 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: ��
Original.• 1-Address File
Make Copies For: 1- Utility Billing Department I- Cash Drawer