HomeMy WebLinkAbout2008-00200 - water meter � '�
CITY OF ORONO PERMIT NO.: 2oos-oo2o0
2750 KELLEY PARKWAY
ORONO, MN 55356- �ATE IssuEv: 09/09/2008
952 249-4600 FAX: 952 249-4616
ADDRESS : 2470 COBBLESTONE CT
PIN : 33-118-23-11-0080
LEGAL DESC : STONEBAY SIXTH ADDITION
: LOT 002 BLOCK 001
PERMIT TYPE : WATER METER
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER METER
NOTE: INSPECTIONS ARE DONE BY PUBLIC WORKS DEPARTMENT.
TO SET-UP AN INSPECTION,PLEASE CALL: (952)249-4613
3/4"WATER METER-SERIAL NUMBER 51002172,ERT HIGH#1810197858
WATER METER RES[DENTIAL HORN 1 WATER METER RESIDENTIAL 1
APPLICANT WATER METER RESIDENTIAL 312.40
PLUMB RIGHT WATER METER RESIDENTIAL HORN 61.00
1216 82ND.AVE N
BROOKLYN PARK, MN 55444- MISC FEE 0.00
(763)561-3306 TOTAL 373.40
Minnesota State License#: MN#3314
OWNER
O.T. Development, LLC
LLC,O.T. DEVELOPMENT,
2670 KELLEY PKWY
ORONO, MN 55356
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicablc City approvals,and the
State Building Code. 'i'his pemlit is for only the work described and does
not grant permission for addi[ional or related work which requires separate
permits. All provisions of laws and ordinances goveming this type of work
shail be compied with whether or not specified herein.This permit wili
expire and become null and void if construction authorized is not
commenced within l 80 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 i conformance with the State Building Code.This permit may be
revo� at an time f due cause.
� � / / D
pplicant Permitee Signature Date Issue y Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESC IBE BOVE.
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FOR CITY USE ONLY
,;;���,�\ City of Orono
r(/� �" P•O.Box 66 Date Received: Permit#
� �, , ti� 2750 Kelley Parkway
� �'��. r.�o�� (952)249-46 ON 55323 Approved By:(If Required):
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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 will 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 1
�Residential (May Require Approval) ❑Commercial(Approval Required)
❑ New Meter � Additional Meter—For: �Replacement Meter
Job Site/Owner Information:
Site Address: � / �� ��,�f �n-tj7j ��.
Owner: �- �� Mailing Address:
City: Zip:
Home Phone: Alternate Phone:
Contractor Information:
Contractor: Contact Person: ��
i h
Address: /'� —� - ��State License#: �� � 7� �����/<�
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City: � , G' Zip:.���yExpiration Date: Z
Phone: J��-�,J���/�� Alternate Phone:
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WATER METER PERMIT FEES
WTLL 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&PR[CES 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: ��Q.._,Q�"(�{�J L/
SIZE: ❑ 5/8" �3/4" ❑ 1" ❑Other "
SERIAL#: SI�Q�I / o�
ERT HIGH#: ����������������������������I if a
- 1810197858 (� pplicable)
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.
, � �y �/
Applic Date: �J l/O
� Reset Form �
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Original.• 1-Address File
Make Copies For: 1- Utility Billing Department 1-Cash Drawer