HomeMy WebLinkAbout2014-01075 (water meter) CITY OF ORONO * 2 0 1 4 - 0 1 0 7 5 �k
� 27>0 KELLEY PARKWAY DATE ISSUED: 09/22/2014
ORONO, MN 55356-
(952) �49-4600 �AX: (952) 249-4616
ADDRESS : 3225 CASCO CIR �
PIN : 20-ll 7-23-43-0021
LEGAL DESC : SPRING PARK
: LOT 029 BLOCK 000
PERMIT TYPE : WATER METER-RESIDENTIAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER METER-RESIDENTIAL
,
NOTE: INSEPCTIONS ARE DONE BY PLJBLIC WOKKS DEPARTMENT. ';1�'
TO SBT-UP AN INSPECTION,PLEASE CAi,L: (952)249-4613
WATER METER RESIDENTIAL HORN 1 WATER MF 1
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APPLICANT WATER METER RESIDENTIAL 392.92
WATER METER RESIDENTIAL HORN 104.45
SPRING PLUMB[NG LLC TOTAL 497.37
11473 KENYON COURT
BLAINE, MN 55449- Payment(s)
(763)614-7963 CREDIT CARD 3580 497.37
Minnesota State License#: plbg-066807 PM
OWNER keceipt No: 3.U11838 Sep 2Z 2014
LEESTMA, MARTIN& KATHRYN
3225 CASCO C1R Spriny Plumbiny Inc
WAYZATA, MN 55391-
Previous Balance: •��
Sale Of Wtr Meter
P2014-Ot-75 4y7.37
AGREEMENT AND SWORN STATEMENT 601-'39610
The work for which this permit is issued shall be performed according to M 1SC0 i 18neGiJS ReVBt iue
the approved plans and specifications,applicable City approvals,and the ------ -�-
State Building Code. This permit is for only the work described and does TO t81: 497•��
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 Credi t Card
expire and become null and void if construction authorized is not CheCk No: 3580 497.37
commenced within 180 days of the date of issuance,or if construction is PayOr:
suspended for a period of 180 days at any time after work has commenced. Spi`1�I�a P 1 Umh 1 ng I f'iC
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.
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Applicant Permitee Signature Date Issued By Signature Date
FaR crrr uss arR,x
OCity of Or000
/� P,U.13ax 66 Dute Receivnd; PcmRit k
� V 2750 Kelley Padcway
Crye�W Bey,MN 55323 Ag�roved Ay,(If Raquuod);
(932)249-46q0
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�� CITY QF ORONO�-WA.TER M�TER FORM
�'�kf S H�Q'� �.Np� �me pctmitn muy tcyuire epprovel by the Ruilding Off'icisl und/ut Publie Wodcs DeparCnant
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GEN�RAL INFORMATION
1, WAT��t METERS must be picked up arnd paid for at Ciry Hall.
2. Tf uossib�e,fax in this application ahead of timc;we will then call you and let you know we have
the wAter mener in steek. Fax Number: (952)Z49-4616. Also,you can call pheAd of time to make
sure we received the fax,or to wam us th�t the fax ig caming.
3. WATER ME'�ERS must be eet and sealed by Orono Water Department (952} 249-4600,
upon completion o(metcr installation.
TYP�Q�'�1tNllT
Check All That A 1
�Residential(May lZequire Approval) ❑Commercial(Approval Required)
�New Metqr ❑Additional Meter—For� ❑Replacomant Meter
Job Site/Ow�er In�orma#ion:
Site Address: ��"�� e-���"'`� `-"' ` �
Owner; Mailing Address'
City: - - Zip:
Horne Phone: Alternate Phone:
Contractor Informatiora:
Contractor: � � �UIVI��/y Contact Person: �t(��l� �7'u.�41�'1
Addr�ss: ����� ���i U�'� a` state i.icense#: �� � � 3 B ��
City� � t�� Z�p����1� Expiration Date: �a �
Phone: ���1 " �I� "7 y y 3 Alternate Phone: - ^
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WATER METER PERMIT FEES
WILL BE CAULULATED BY CITY STAFF
g5/8"METER- ❑ 3/4"ME'T'�R- 1":vIE'I'B2t-
SB"HORN - ❑ 3/4"HORN - 1�.HORN -
� "W ATER MET�R (TH6SE W I'LL�IAYE TO B&SPECUL O�i D�RED&PRICES DET&RM'JNED)
1, METER FE�: � --
2, f-�ORN PEE �
3. TOTAL PR�tNIIT FEE(Add Lincs 1-2 Above) S
CITY-USE 4NLY
* For C�urrent Pricing Refer to Gurrent Year-Water Meter Pricing Chart*
sx.��:
S1ZE: �5l$" ❑3/a" ❑ 1" ❑Othar,_„�"
SERIAL#:
ERT HIGH#: (if applicable)
ADDITiQNAL INFOR1v�AT10N—WATER METERS
� The undersigned hereby applies to the City of Orono for issuance of a water meter permit, agrees
to do a11 work in strict accordance with the ordinances of the City and the regulations of khe State
af Minnesota,and certifies that all statet�ents made on this application are,true and coxrcct.
Applicant: �- � �` ��� Date' � � I1
OHginal: 1-Address File
Make Co,pies Fiar: 1-UAlity Billing Deparrmenl 1-Cash DrmNer
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