HomeMy WebLinkAbout2014-00565 - water meter ' ' CITY OF ORONO
2750 KELLEY PARKWAY * z 0 1 4 - 0 0 5 6 5 *
DATE ISSUED: 06/06/2014
� ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2807 CASCO POINT RD
PIN : 20-117-23-32-OO14
LEGAL DESC : SPRING PARK
: LOT 123 BLOCK 000
PERMIT TYPE : WATER METER- RESIDENTIAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER METER- RESIDENTIAL
NOTE: INSEPCTIONS AR�DONE BY PUBLIC WORKS DEPAR"['MF-,NT.
TO SET-UP AN INSPECTION,PLEASE CALL: (952)249-4613
WATER METER RESIDENTIAL HORN 1 WATER METER RESIDENTIAL 1
APPLICANT WATER MET'ER RESIDENTIAL HORN 104.45
WATER METER RESIDENTIAL 392.92
MATT'S PLUMBING SOLUTIONS
5565 164TH AVE NW TOTAL 497.37
RAMSEY, MN 55303- Payment(s)
(651)341-5899 CREDIT CARD 2805 497.37
Minnesota State License#: plbg-068021-PM
OWNER
BAILEY, JOHN& PATRICIA
2807 CASCO POINT RD.
WAYZATA, MN 55391-
AGREEMENT AND SWORN STATEMENT
I he work for which this permit is issued shall be performed according to
the approved plans and specitications,applicable City approvals,and the
State Building Code. This permit is for only the H�ork described and docs
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 witli whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 1 AO 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 in conformance with the State I�uilding Code.'Chis permit may be
revoked at y[i e tbr d cause.
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Applicant Permitee. gnature Date Issued By ign e Date
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FOR CITY USE ONLY
City of Orono
�-O�O P.O.Box 66 Date Received: Permit#
2750 Kelley Parkway
Crystal Bay,MN 55323 Approved By:(If Required):
(952)249-4600
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�qkESNo��G CITY OF ORONO—WATER METER FORM
(*Note:Some permits may require approval by the Building Official and/or Public Works Department
*�
GENERAL INFORMATION
1. WATER METERS must be picked up and paid for at City Hall.
2. If possible,fax in this application ahead of time; we wili then call you and let you know we have
the water meter in stock. Fax Number: (952)249-4616. Also,you can call ahead of time to make
sure we received the fax, or to warn 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 PERMIT
(Check All That A ply)
�] Residential (May Require Approval) ❑ Commercial(Approval Required)
�{New Meter ❑ Additional Meter—For: �Replacement Meter
Job Site / Owner Information:
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Site Address: � �b � ��, (� �G''�/I`t" ���
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Owner: %!/1l Mailing Address: � I�b � ��'����`'�'��� ��
city: �>��`C�C� zi `5�� �
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Home Phone: Alternate Phone:
Contractor Information:
Contractor: l(�fS >G'GY'�c�Contact Person: ��� '.SSC�
Address: �14��0 Iy���'�`e State License #: /`����'Z� �2
City: � � � � Zip:-S��d � Expiration Date: /2 �� ���
Phone: �7�P��(�j'���� Alternate Phone: ��'3 ��� ��'"�����5
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WATER METER PERMIT FEES
WILL BE CAULULATED BY CITY STAFF
❑ 5/8" METER- ❑ 3/4" METER- 1"METER-
❑ 5/8"HORN - ❑ 3/4"HORN - i"HORN -
❑ " WATER METER (THESE WILL HAVE TO BE SPECIAL ORDERED&PRICES DETERMINED)
1. METER FEE: $
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: ��'�'(,L,ti.Q
SIZE: ❑ 5/8" ❑ 3/4" �–t" ❑ Other "
SERIAL#: SZ�� � C� � �
ERT HIGH#: ��������������I�������������i (if applicable)
— 1834354828
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.
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Applicant: � ' � �=%��/ Date: �L'��'
Original: I-Address File
Make Copies For: 1- Utility Billing Department 1-Cash Drawer