HomeMy WebLinkAbout2015-00243 (water meter) � � � CITY OF ORONO * 2 B 1 5 - 0 0 2 4 3 *
t 2750 KELLEY PARKWAY DATE ISSUED: 02/2'7/2015
ORONO, MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS : 3759 CASCO AVE
PIN : 20-117-23-31-0010
LEGAL DESC : CASCO HEIGHTS
: LOT 000 BLOCK 004
PERMIT TYPE : WATER METER-RESIDENTIAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER METER- RESIDENTIAL
NOTE: INSEPCTIONS ARE DONE BY PUBLIC WORKS DEPARTMENT.
TO SET-UP AN INSPECTION,PLEASF.,CALL:(952)249-4613
3/4"NEPTUNE WATER METER
SERIAL#52155579
ERT HIGH# 1831448112
WATER METER RESIDENTIAL HORN 1 WATER METER RESIDENTIAL 1
APPLICAPIT WATER METER RESIDENTIAL 294.42
WATER METER RESIDENTIAL HORN 80.42
BLUE WATER PLUMBING M[SC FEE 0.00
5026 ALPHA ROAD
PRINCETON,MN 55371 TOTAL 374.84
(763)238-1002 Payment(s)
Minnesota State License#: plbg-PC001640 CHECK 374.84
OWNER
TONKA DEVELOPMENT
216 WATER STREET
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 I80 days of the date of issuance,or if construction is
suspended for a period of 180 days a[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
revoked at any time for due cause.
i!� �.-� 7� / � � �� � �a�7 �/J�
icant Permitee Signature Date Issu By Signature Date
1 .
FOR CITY USE ONLY
�O�O City of Orono
P.O.Box 66 Date Received: Permit#
2750 Kelley Parkway
Crystal Bay,MN 55323 Approved By:(If Required):
(952)249-4600
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�qk�SHo��,�' 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 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 � �c�
�
Owner: ���3 ScJ/� Mailing Address:
City: Zip:
Home Phone: Alternate Phone:
Contractor Information:
Contractor: ���� t.v��� p����� N�ontact Person: ��S � J��--� �`
Address: ��(� �� ��� State License #:
City: �r'i'�w�'b� Zip: 5�7� Expiration Date:
Phone: 7G3 � �'�8� /��a" Alternate Phone: 7C 3 -3�� --�y8�
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WA1'ER METER PERMIT FEES
WILL BE CAULUL�TED BY CITY STAFF
❑ 5/8"METER- "METER- ❑ 1"METER-
❑ 5/8"HORN - 4" HORN - ❑ 1"HORN -
❑ "WATER METE (THESE WILL HAVE TO BE SPECIAL ORDERED&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: ����� �
SIZE: ❑ 5/8" �3/4" ❑ 1" ❑ Other "
SERIAL#: .5 �! J S�� �
ERT HIGH #: IIIIII II IIII IIIII IIIII II IIIII (if applicable)
1831448112
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.
Applica . /� C/ Date: �'—a,r / �
Original: 1-Address File
Make Copies For: 1- Utiliry Billing Department