HomeMy WebLinkAbout2013-00012 (water meter) � CITY OF ORONO * z 0 1 3 - 0 0 0 1 z *
2750 KELLEY PARKWAY DATE ISSUED: OU07/2013
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 3165 CASCO CIR
PIN : 20-117-23-43-0026 ,-
LEGAL DESC : SPRING PARK
: LOT 036 BLOCK 000 �
PERMIT TYPE : WATER METER- RESIDENT[AL � �
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER METER- RES[DENT[AL
NOTE: INSEPCT[ONS ARE DONE BY PUBL[C WORKS DGPARTMEN'I.
TO SET-UP AN INSPECTION,PLEASE CALL:(952)249-4613
NEP"1'UME- 1"WAT�R METER
SERIAL#-51390856
ERT HIGH# 1820470241
WATER METER RESIDENTIAL HORN 1 WATER METER RESIDENTIAL 1
APPLICANT WATER METER RESIDENTIAL 392.92
STEWART PLUMBING, INC. WATER METER RESIDENTIAL HORN 104.45
13025 GEORGE WEBER DR
SUITE#1 TOTAL 497.37
ROGERS, MN 55374 PAID WITH CC# 3122
(763)428-1833
OWNER
ARMSTRONG, WARD&KATHLEEN
6898 EDGEBROOK PLACE
EDEN PRAIRIE, MN 55346-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be perfonned according to
the approvcd plans and specifications,applicable City approvals,and thc
State Building Code. "Chis pem�it is for only the work described and does
no[grant permission for additional or related work which requires separate
perniits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or no[speciticd 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 I3uilding Code.'Chis permit may be
revoked at any time for due cause.
��� / � / 1� / /� -] / /�
n �cant Permitee Signature Date Issue '�nature Date
SEPARATE PERMITS REQU[RED FOR WORK OTHER THAN DESCR[BED ABOVE.
Jan 0713 03:;i5p Stewart Plumbing In�. 763-428-1733 p.1
I
+ FOR C TY USC ONLY
` � City of Ocouo j �
%Og��O"1 P•O.Box 66 Dabe Received:/7 ren,��c# ��3 a b�
• �,�� �I 2750 KeUey Parkway
i`� r"�.,' . �a'�; Crystal Bay,MN 55323 Approt�ed By:(►f Etequired):
\��� (9�21249-4600
,`` __�
CITI' OF ORONO—WATER MET�R FORM
(�'Nofe:Somc pcnnits may require approval by thc Building Oflicial and/or Public Warks Aepartrncnt')
GENERA�L [NFO�tMATION
I. WA3'ER METERS must be picked up and paid for at Ciry Hall,
� 2. lf possible, fax in this appEication ahead of time;we will then call yau and let you kno�v we have
the water meter in stock. Fa�c Number:(952)249-4616. Also,you can call ahead of time to make
sure we received the fax,or to vvam 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 PERMl'F
Check All That A l
❑ IZesidential (l��Eay Require Approval) �Commercial(Approvat Required)
�New ilileter ❑ Additional Meter—For: []�Replacement Meter
Job Site/Owner Information:
�
Site Address: �J l�`� (11��� �,,��l":.�Q,
Owner: ��1�T�L`�lq Mailing Address: Gc,� b��`� ' �(..
City: �.'IF�n `YrC1��(�Z Zip: 553�1
Home Phone: Alternate Phone:
Contractor]nformateon:
Contractor: •��i.L��f� �I l;�tY���'fl I
, �.�riC.Coniact Person: �1�r��-�C.'� C?,Y�(Y�(�
Address: �1� ��� l^i'o!c e ;�.'�v �rState License #: L�`3��
� `
City: � � �(S Zip:� Expiration Date: M�i 31- ��
,
Phone: �1(�3-y��� ��3� Altemate Phone:
Jan 07. 13 03:35p StewartPlumbing Inc. 763-428-1733 p.2
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�
i � �
WATER METER PERMIT FEES
WILL BE CAULULATED BY CITY STAFF
I 4
� ❑ 5/8"METER- ❑ 3/4"METER- � 1"METER-
❑ 5�8"HORN - ❑ 3/4"HORN - � 1" HORN -
� "WATER METER (THESE WLLL HAVE TO BC SP�ClAL ORDERED&PR[CES DETGRMiNED)
I
1. �IETER FEE: $
2. HO[�N FEE $
3. TUTAL PERMIT�'EE(Add Lines 1-2 Above) $ �T I l s J I
I CITY-USE ONLY
* For Current P�icing Refe to Current Year -Water lbieter Pricing Chart *
BRAND: � � _
SIZE: ❑ �i'8" ❑ 3,'4" �" �Other "
SERIA�,�: S���Q O ��
ERT HIGH#� ' III III IIII HI���������������� (if app I icable)
1820470241
ADPJITIONAL 1NFOR11�1ATION-VVATER METERS
The undersigned hereby applies to the City of Orono for issuance of a water meter perrnit,agrees
to do all wor(c in strict accordance with the ordinances of the City and the regulations of the State
of Minnesota, and certifies that ail statements made on this application are,�ue and correct.
�/�� � ,
Applican�'�-.- Ci�-'`�ty2.�� Date: � �-�� -
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Reset Form
Origi»al: I-Address FiJe
Make Copies Fvr: 1- Utili[y Bidling Departmeni I-Cash Drawer
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