HomeMy WebLinkAbout2013-00766 - water meter ' - � CITY OF ORONO * z 0 1 3 — 0 PJ 7 6 6 *
2750 KELLEY PARKWAY �AT��sSUE�: 08/15/2013
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2794 CASCO POINT RD
PIN : 20-117-23-32-0018
LEGAL DESC : CASCO HEIGHTS
: LOT 022 BLOCK 004
PERMIT TYPE : WATER METER-RESIDENTIAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER METER- RESIDENTIAL
NOTE: INSPECTIONS ARE DONE BY PUBLIC WORKS DEPARTMENT.
TO SET-UP AN INSPECTION,PLEASE CALL:(952)249-4613
3/4"NEPTUNE WAT�R MLTGR&HORNS
ERT HIGH#1831526787
SERIAI,#52191609
WATER METER RESIDENTIAL HORN 1 WATER METER RESIDENTIAL 1
APPLICANT WATER METER RESIDENTIAL 303.70
MIKE LARSON PLUMBING WATER METER RESIDENTIAL HORN 86.64
5120 HOOPER LAKE ROAD
DEEPHAVEN, MN 55331- TOTAL 390.34
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Minnesota State License#: 059193
OWNER
Narge Development LLC
30 BIRCH BLVD
TONKA BAY, MN 55331-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
[he approved plans and specitications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not gran[permission for additional or related work which requires separate
permits. All provisions of laws and ordinances goveming this type of work
shall be compied with whether or not specitied hereia 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 a[any time after work has commenced.
The applicant is responsible for assuring all required inspecti "s are
requested in conformancc with the S[ate Building Code.T s permit may bc
revoked at any tim for due cause. �
' �� � � / /
Ap cant er rtee Sig r " Date Issued y Si ture Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER T AN DESCRIBED ABOV .
FOR CITY USE ONLY
City of Orono
� �O�O\ P.O.Box 66 Date Received: Permit#
�� 2750 Kelley Parkway
Crystal Bay,MN 55323 Approved E3y:(If Required):
� (952)249-4600
, �, '
� � � :
F� j' CITY OF ORONO—WATER METER FORM
�KF�F���� (*IYote:Some permits may require approval by the Building Official and/or Public Works Departmcnt
#)
GENERAL INFORMATION
l. WATER METERS must be picked up and paid for at City Hall.
2. I�ossible,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 cail ahead of time to make
sure we received the fax,or to warn us that the faY 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 A 1 )
❑ Residential(May Require Approval) ❑Commercial(Approval Required)
(�New Meter ❑ Additional Meter—For: ❑ Replacement Meter
� `
Job Site/Owner Information:
Site Address: ��� ��j�� ��• �da�
Owner: Mailing Address:
City: Zip:
Home Phone: Alternate Phone:
Contractor Information:
Contractor: �r� Contact Person: �ll�i�
Address: ���'U r�a�D_�� �State License#: Sy� � 3
City: ��c �� Zip: 5��3 �Expiration Date: �a ' �� � ��
Phone: {�lZ- 3�3 - l�%'� ,3�3 6� 5/
Alternate Phone: 6/a �
WATER METER PERMIT FEES
WILL BE CAULULATED BY CITY STAFF
❑ 5/8"METER- 3/4"METER- ❑ 1"METER-
❑ 5/8"HORN - 3/4"HORN - ❑ 1"HORN -
❑ "WATER METER (THESE WILL HAVE TO BE SPECIAL ORDERED&PRICES DETERMINEll)
l. METER EEE: $
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: �� J� 2/� l�o O �
i
SIZE: ❑ 5/8" �3/4" ❑ 1" ❑Other "
sER�aL#: 1111111�Ia1311512167181111111
ERT HIGH#: (if applicable)
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.
✓ ��
Applicant: — Date: � ` /�
Origina[: 1-Address File
Make Copies For.• 1- Utility Billing Department 1-Cash Drawer