HomeMy WebLinkAbout2014-00811 (water meter) � � CITY OF ORONO * 2 0 1 4 - 0 0 8 1 1 *
2750 KELLEY PARKWAY �AT� ►ssUE�: 07/30/2014
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 3227 CASCO CIR
PIN : 20-117-23-43-0056
LEGAL DESC : SPRING PARK
: LOT MB BLOCK MB
PERMIT TYPE : WATER METER- RESIDENTIAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER METER- RESIDENTIAL
NOT'E: INSF,PC�I'IONS ARE DONE [3Y PUF3LIC WORKS DF,PAR"I'MEN"I'.
TO SF;T-UP AN INSPECTION,PLEASG CALL:(952)249-4613
N�PTUNE 1"WATER METER
SF,RIAL#52648045
ER'I'HIGH# 1834340834
WATER METER RESIDENTIAL HORN 1 WATER METER RESIDENTIAL 1
APPLICANT WATER METER RESIDENTIAL 392.92
WATER METER RESIDENTIAL HORN 104.45
STEWART PLUMBING, INC. MISC FEE 0.00
13025 GEORGE WEBER DR
SUITE#1 TOTAL 497.37
ROGERS, MN 55374 Payment(s)
(763)428-1833 CHECK 12422 497.37
Minnesota State License#: plbg-PC000474,mech-MB003262
OWNER
O'ROURKE, JAMES
1 181 VAGABOND CT N
PLYMOUTH, MN 55447-
AGREEMENT AND SWORN STATEMENT
I�he work for whieh this permit is issued shall be performed according lo
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only thc work described and docs
not grant permission lor 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 auUiorized 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 afrer work has commenced.
The applicant is responsible for assuring all required inspections are
requested i �onfonnance with the State Building Code.1'his permit may bc
revoked an time � r duc c� s .
r �
���o (� �t�t D� /
Applicant Permitee Signature Date Issu By Signature Date
Jul 30 14 10:08a Stewart Plumbing Inc. 763-428-1733 p.1
FO Cl�'Y USE O:YLY
�O City of Orono ,/ /
�O T'.0.Box 66 Date Received� �mit# �
2750 Kelley Parkway /
Crystal Bay,A4N 55323 Approved By:([f Required):
(952)249-460D
� �
.�y� ;
�q'rfSH��E.� CITY OF'ORONd—WATER METER FORM
(*Note:Some permits may require approva�by lhe IIuilding Official and/or PubGc Works Departrnent
.�
GENERAL iNFORMATION
l. WATF,R METERS must be picked up and paid for at City Hall.
2. Ifpossible,fan in this application ahead of time;we will then calt you and let you know we have
the water meter in stock. Fax Number:(952)249-4616. Also,you can call ahead oftime to make
sure we received the fax,or to warn us that the fax is coming.
3. WATER M�TERS must be set and sealed by Orono Water Department (952) 249-4600,
apon completion of ineter installatioa.
TYPE OF PEfLNiIT
(Check All That Apply)
Residential(May Require Approval) ❑Commercial(Approval Required)
U New Meter ❑ Additional Meter—For: ❑Replacertaent Meter
Job Site/Owner Information: �
Site Address: �t�� ��SCI� C �F�-C-�i,
i c
Owner: �� �C��� �.K� MaiiingAddress: J�+''�L
City: ���'�C�) Zip: .-�� � .�� �
Home Phone: Altemate Phone:
Contractor Information:
� C
Cantractor: S��'r�-� t"LJ M�'�� i'�Cj Contact Person: �� I�
Address: 1 7L�C'�� �:�% ���-�fitate License#: ���� �r�
n
� ( ��n �� x iration Date:
City: — Zip: _ p
Phone: ������ - ��`�� Alternate Phone: ��� �3����j � �
- .� ►, ;� -- -
Jul 30 14 10:09a Stewart Plumbing Inc. 763-428-1733 p.2
WATER METER PERMTT I��:ES �
W[LL BE CAULULATED BY CITY 5TAFF i
❑ 5;'8"l�9ETER- ❑ 3!4"1�1ETER- �'METER-
❑ 5!8"HORI�' - ❑ 3!4"HORN - ❑ 1"HORN -
❑ "WA'I�ER l�iETER (THESE W ILL HAV�TO BE SPECIAL ORDERED&PRiCGS DETERI�TINED)
1. vtETER FEE: S
2. HORN FEE $
3. TOTAG PERMIT FEE(Add Lines 1-2 Above) e
��CITY-USE ONLY
* For Current Pricang Refer to Cunent Year-Water Meter Pricing Chart *
B�N�: N�.A-��e _
SIZE: ❑ �/3" ❑3%4`: '�i" ❑Other "
SEItI.AL#: ��_�'�_� �
�R�r Kl�x�: IIIIIIIIIIII IIIIIIIIIIIIIIIII (if applicable)
-- 1834340834
ADDITIONAL 1'VFORMATION—WATER A�ETERS ----�-_��
The undersigned hereby applies to the City of Orono for issuance of a water meter perniit, agrees
to do afl �vork in strict accordance with the ordinances of the City and the regulations of the State
of Minnesota, and certifies that all siatements made on this application are,true and correct.
� � � `
_ —7 ( J
Applicant: � '� I ��-�v�'L Date: r 3� `�t
Original: 1-�cldress File
.Make Capies For: 1-Utiliry BillifJ,�Depurtirrent 1-Cash Drawer