HomeMy WebLinkAbout2010-00682 (water meter) '� ' ' CITY OF ORONO PERMIT NO.: 2010-00682
2750 KELLEY PARKWAY
ORONO, MN 55356- �ATE ISSUED: 08/09/2010
952 249-4600 FAX: 952 249-4616
ADDRESS : 2447 CARMAN ST
PIN : 20-117-23-12-0014
LEGAL DESC : NAVARRE
: LOT 007 BLOCK 002
PERMIT TYPE : WATER METER
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTIOIY TYPE : WATER METER
NOTE: INSPECTIONS ARE DONE BY PUBLIC WORKS DEPARTMENT.
TO SET-UP AN INSPECTION,PLEASE CALL:(952)249-4613
CONTRACTOR DID NOT NEED TO REPLACE THE HORNS �
5/8"WATER METER
SERIAL NUMBER: 89137810
ERT HIGH# 1830857899
WATER METER RESIDENTIAL 1
APPLICANT WATER METER RESIDENTIAL 268.05
DOUG'S PLUMBING
4908 WILLISTON ROAD TOTAL 268.05
MINNETONKA,MN 55345
(952)457-4867
OWNER
BLUTH,JOSEPH
2201 WEST DREAM DRIVE
NORTH MANKATO, MN 56003-
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 conformance with the State Building Code.This permit may be
revoked at any time or ue use.
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Applicant Per tee Sign ture Date Issu By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
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' FO ITY USE ONLY
0,�` City of Orono 0�8'�/
O4 `rO P.O.Bax 66 Date Received: ermit# D ���
�,�,r„2 2750 Kelley Parkway
�d�����ri�o�G�F (952)2 4a46 ON 55323 ApProved By:Qf Required):
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CITY OF ORONO-WATER METER FORM
(*Note:Somc 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 applicarion 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 ineter installation.
TYPE OF PERMIT
(Check All That Apply)
�esidential(May Require Approval) ❑ Commercial(Approval Required)
❑ New Meter ❑Additional Meter—For: ❑ Replacement Meter
Job Site/ Owner Information: ��
Site Address: 02.`�`11 Co�m�v�
Owner�oes ��L.v'S'tl Mailing Address:
City: blz�o zip:
Home Phone: 5� • 381� 0�17p Alternate Phone:
Contractor Information:
Contractor: � S �� �►1� Contact Person: �G 'h��X+-���S T-
Address: �O�j �.,���Srw, -�e.� State License #: D 5958v
City: f�'1'CY� Zip�S Expiration Date: �L �'�1 � � C�
Phone: ciK� �3 3• Z 8 3 C Alternate Phone:
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� � � �� � 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)
1. METER FEE: $ ��O CJ � �
2. HORN FEE $
3. TOTAL PERMIT FEE(Add Lines 1-2 Above) $ ���' v`-�
CITY-USE ONLY
* For Current Pricing Refer to Current Year- Water Meter Pricing Chart *
BRAND: ���'(,(J��,
SIZE: �5/8" ❑ 3/4" ❑ 1" ❑ Other "
SERIAL#: o I � ��o ��
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ERT HIGH#: 1830857899 (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.
Applicant: ���`�r Date:
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Original: 1-Address File
Make Copies For: 1- Utility Billing Department 1- Cash Drawer