HomeMy WebLinkAbout2010-00023 (water meter) ' CITY OF ORONO PERMIT NO.: 2010-00023
2750 KELLEY PARKWAY
ORONO, MN 55356- �ATE IssuEn: OU20/2010
952 249-4600 FAX: 952 249-4616
ADDRESS : 3127 CASCO CIR
PIN : 20-117-23-34-0022
LEGAL DESC : COLORADO SPRINGS
: LOT 002 BLOCK OOl
PERMIT TYPE : WATER METER
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER METER
NOTL,: INSEPCTIONS ARE DONE BY PUBLIC WORKS DEPARTMENT.
TO SET-UP AN INSPEC"]'ION,PLEAS�CALL:(952)249-4613
WATER METER RESIDENTIAL HORN 1 WATER METER RES[DENTIAL 1
APPLICANT
WATER METER RESIDENTIAL 394.67
STEWART PLUMBING, INC. WATER METER RESIDENTIAL HORN 104.45
13025 GEORGE WEBER DR
SUITE#1 TOTAL 499.12
ROGERS, MN 55374
(763)428-1833
OWNER
PETERS, FREDERICK
3127 CASCO CIR
WAYZATA, MN 55391-
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 rcquires separate
permits. All provisions of laws and ordinances goveming 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 atter work has commenced.
The applicant is responsible for assuring all r ired inspections are
requested in conformance with the State �Iding Code.This permit may be
revoked at a me for due cause.
1 / / / /
Applicant Permitee Signature Date Issuc [3y nature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB .
FOR CITT L�SE t)NLI�
;¢�� Cit��of Orono
OQ P-O.Box 66 Datr Rccei�ed: ____ Yrntut= ______
2750 Kelley Parkway
a ^. � Crystal Bay,MN 55323 _\ppro�eJ B�-�If Raqoired�:
�� 't„'4 r�a` (952)2d9-4600 ----- ---- .)
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CITY OF ORONO—WATER METER FORM
('Note:Some pem�its may require approval by the Building�cial and/or Public Worke Department*)
GENERAL INFORMATION
1. WATER METERS must be picked up and paid for at City Hall.
2. If possible,fa�c in this application ahead of time;we will then cali you and let you know we have
the water meter in�tock. Fa�c Number: (952)249-4616. Also,you can call ahead of time[o make
sure we received the fax,or to wam us that the fa�c is coming.
3. WATER METERS must be set and sealed by Orono Water Depariment (952) 249-4600,
upon completion of ineter installation.
TYPE OF PERMIT �
� Gieck All That A 1 )
Resiilential(Ma� Require flPpro��il) ❑Commercial(Approval Requireci)
�w Meter �Additional Meter—For: �Replacement Meter
Job Site/Owuer Information:
n
Site Address: ��Z� �'�`�(� 1..1i L��.
Owner: FY�L���1C�L �e��� Mailing Address: _
City: Zip: —__
Home Phone: Alternate Phone:
Contractor L�formation:
Stewart Piumbing, Inc. Pam Baker
Contractor: Contact Person:
Address: 13025 George Weber Dr#1 State License#: 061344-PM
12l31/2009
City; R°9e� Zlp: 55374 Expiration Date:
Phone: (�63)428-1833 Alternate Phone:
'�WATER METER PERMIT FEES
WILL BE CAULULATED BY CITY STAFE
❑ 5/8"METER- ❑ 3/4"NIETLI2- v�"MI:TER-
v
❑ 5/8"HORN - ❑ 3/4"HORN - 1"HQRN -
❑ "WATER METER (THESE WILL I3AVE TO BE SPECIAL ORDEREll&PIZICES DETEIiMINED)
I. METER FF,E: $
2. HORN FEE $
3. TOTAL PERNII'T FEE(Add Lines 1-2 Above) � �"f-I , ��
c1�-usE or�,Y �
* For Current Pricing Refer to Current Yea.r-Water Meter Pricing Chart *
B�: �U P�o fc�,w�,
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SE��,#: s�3408�o
ERT HIGH#�: �����������������I����������� (if applicable)
— 1820457035
ADDITT4NAL INF4RMATION—WATER METERS
The undersigned hereby applies to the City of Orono for issuance of a w�ater meter permit, agrees
to do all work in strict accordance with the ordinances of the City and the regulations of the State
of Minneso�a and certifies that,all statements made on this application are, true and correct.
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A�rlicant: � r � , Date: _����j�
Reset Form
Original: 1-Address I ile
�t�lake Copies For. 1- Utility Billrng Department 1-Cash Drawer