HomeMy WebLinkAbout2010-00823 - water meter � CITY OF ORONO PERMIT NO.: 2010-00823
� 2750 KELLEY PARKWAY
ORONO, MN 55356- DATE [SsuEn: 09/14/2010
952 249-4600 FAX: 952 249-4616
ADDRESS : 1785 CONCORDIA ST
PIN : 17-117-23-22-0016
LEGAL DESC : COFFEES ADDN TO SHADY WOOD LAK
: LOT 000 BLOCK 000
PERMIT TYPE : WATER METER
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER METER
NOTG: INSEPCTIONS ARE DONE BY PUBLIC WORKS DrPAR"l MENT.
TO SE"f-UP�N INSPECTION,PLEASE CALL: (952)249-4613
NEP'fUNE WATER METER- 1" -SEKIAL NUMBEK-51390859-I?RT- 1820457161
WATER METER RESIDENT[AL HORN 1 WATER METER RESIDENTIAL I
APPLICANT WATER METER RESIDENTIAL 394.67
STEWART PLUMBING, WC. WATER METER RESIDENT[AL HORN 104.45
13025 GEORGE WEBER DR
SUITE#1 M[SC FEE 0.00
ROGERS, MN 55374 TOTAL 499.12
(763)428-1833
OWNER
DULIN, KEV[N& BARBARA
1785 CONCORDIA ST
WAYZATA, MN 55391-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Codc. This permit is for only the work described and docs
not grant permission for additional or related w�ork which requires separate
pennits. All provisions of laws and ordinances governing this type of work
shall be compicd with whe[her or not specitied herein.This permit will
expire and become null and void if construction authorized is not
commenced wrthin 180 days of the date of issuance,or if construction is
suspended for a period of�180 days at any time after work has commenced.
I�he applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may bc
revoked at any time for due cause.
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��1icant Permitee�gnature � Datc Issu By Signature Date
� SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
Sep�.O 2010 7: 56RM STEWRRT PLUMBING 7634281733 p. l
�
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FOR CITY US�ONLY
�p� City of Orono
o :. o P O.Bmc 66 Dateltecei��ad 9�,��►,�� aOio -o �z3
�; 2750 Kelley Parkway
> Crystal Bay,MN 55323
L; �� (452)Z49-4600 ApP�O�'�By:(If Aequired):
��O
CITY OF ORO O—WATER METER FORM
("Note:Some pennits may rcquire appr val by thc 8uilding Official and/or Public Works Department�)
GENERAL INFORMATION
(. WATER METERS must be picke up and paid for at City Ha1l.
2. If ossi e fax in this application ead of time;we will then call you and let you know wa have
the water met�in stock. F�Num r:{952)249-4616. Also,you can caJl ahead of time to make
sure we received the fa�c,or to w us that the fa�c is coming.
3. WATER METE85 must 6e aet and sealed by Orono Water Department (952) 249-4600,
npon completion of ineter insta] tion.
- T E 4F PBR1VfIT
C}� ck.All�'hat A I
❑Residendal(May Require Approval) []Commercial(Approval Required)
�New Meter []Additional M ter—For:
❑Replacement Meter
Job Site /Owner Tnformation:
Site Address: ���5 WY1(�,fl�' rj�' p�,-�'Q
Owner: Mailing Address:
City: Zip:
Home Phone: Alternate Phone:
Contractor Infartnation:
C ontractor: � P��► �,. Conta.ct Person; Qy�� (
Address: 13t�2.� l�e�r�,� �r pr State License#: �1�� ip m
City: � Zip. 3�} Expiration Date: _ 1��31��p
Phone: �l(a3-�}Z�- 1�33 Alternate Phone: �pla-3�(�- (��q I
I
Sep�10 2010 7: 56RM STEWRRT PLUMBING 7634281733 p. z
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- ' �7 � ` �''4 � ,' 1�1�T�R. TE� P�".�1 �'E� S "� '
? �y�s �y ' Y�y�'� ✓ 'T '� t-. r 't f N �J
(�V 4 t t !i,1�1��L.f";���_��d 1��LJ.�l� V��l ���1 � k � :1:; i r.S �
❑ 5/8"METER- 3/4" TER- 1"METER-
� 5/8"HORN - � 3/4" ORN - �1"HORN -
❑ "WATER METER (THESE W L IiAVE TO BE SPECIAL ORDERED&PRICES DETERMINED)
1. METER FEE: $ ,?j�y �+7
/
2_ xoRrr r� $ (b�f '�
3. TOTAL PERMiT FEE(Add L nes 1-2 Above) S ���, {�1�
C TY-USE ONLY
* For Cu.rrent Pricing Refer to Curren Year- Water Meter Pricing Chart *
BRAND: ;/� � �- �
SIZE: ❑ 5/8" ❑3/4" �1" ❑ Other "
���.#: 5i �9 8sg
ERT HIGH#: III III IIII I II II III IIII I IIII II (if applicable)
1820457161
ADDITIONAI:II�TF RM�1'�IpN-W.q;'I'ER PvIETERS
The undersigned hereby applies to the Ci of Orono for issuance of a water meter permit, agrees
to do al! work in strict accordance with e ordinances of the City and the regulations of the State
of Minnssota, and certifies that all statem nts made on this applica.tion are,true and correct.
Applicant: ' � 'f� Date: / f� �O
R�s�a�F�r�i �;:
Origirral: 1-Address File
11�fake Copies Far: !- Utility 9illi�g D�partm nt 1-Cash Drawer