HomeMy WebLinkAbout2009-00566 - water meter CITY OF ORONO PERMIT NO.: 2009-00566
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE Iss[1ED: 09/09/2009
� (952) 249-4600 FAX: (952) 249-4616
-;- .
ADDRESS : 2700 ETHEL AVE
PIN : 20-117-23-24-0013
LEGAL DESC : CASCO HEIGHTS
: LOT 000 BLOCK 002
PERMIT TYPE : WATER METER
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER METER
NOTE: INSEPCT[ONS ARE DONE BY PUBLIC WORKS DEPARTMENT.
TO SET-UP AN INSPECTION,PLEASE CALL:(952)249-4613
THEY S'I�ILL HAD THE HORNS,AND SAID THEY ONLY WANTED THE METER.
WATER METER RESIDENTIAL 1
APPLICANT WATER METER RESIDENTIAL 268.05
BRENNAN PROPERTIES LLC TOTAL 268.05
8452 153RD PLACE
SAVAGE, MN 55378- PAID WITH CC# 7119
(612)616-4447
Minnesota State License#: 20381410
OWNER
GHERARDI, LORI
2700 ETHEL AVE
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 Code. This permit 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 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 authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any[ime after work has commenced.
The applicant is respo ble for assuring all required inspections aze
requested i an with the State Building Code.This permit may be
rev at an me fo ie cause. �y
l � l �� �_ G�j�-�l�-�� ���
Applica Permitee ignature Date Issued By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
�' FOR CITY USE ONLY
� � City of Orono `
�� �� P•O.Box 66 Date Received:���� ���"�Permit# �C'UC�' d����
.�, , 2750 Kelley Parkway
� ��l'� �r�:_ Crystal Bay,MN 55323 Approved By:(If Required):
+� r�,�.� (952)249-4600
iqar"�I,f� 4�
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CITY OF ORONO–WATER METER FORM
(*Note:Some permits may require approval by the[3uilding Official and/or Yublic 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: �� � � �7ff�,�,
Owner: �.�v,E'�� Co/`�.�r4�ei:�i� Mailing Address:
City: �CO`J v Zip:
Home Phone: � ��' �7��- �-! Z-Z � Alternate Phone: ��
Contractor Information:
Contractor: ��'�'✓1���� Contact Person: ��� ��{7`/��
Address: �j�S� �53 � �� State License #: o �e ��, ��
/�–._._.
City: ��1J Zip: Expiration Date: ��j ,�7�
Phone: �����1(� �/y�% � Alternate Phone: �—
._
WATER METER PERMIT FEES � t
WILL BE CAULULATED BY CITY STAFF
�5/8"METER- 3/4"METER- 1"METER-
❑ ❑
��_�-3f8"HORN - ❑ 3/4"HORN - ❑ 1"HORN -
❑ �c-'
"WATER METER (THESE WII,L HAVE TO RE SPECIAL ORDERED&PRICES DETERMINED)
1. METER FEE: $ �(../�� � D J
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: �o���( ,� �--"
SIZE: � 5/8" ❑ 3/4" ❑ 1" ❑ Other "
SERIAL#: ��j D ���� �� �
ERT HIGH#: ,�i�II IIII I II IIII IIII I II III II lf a licable
1820812702 �� 1'p )
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 accorda e with the ordinances of the City and the regulations of the State
of Minnesota, and ce ' s at 11 statements made on this application are, true and correct.
Applicar{t----� - Date: �-�`0%
Original: 1-Adclress File
Make Copies For: 1- Utiliry Billing Department /- Cash Drawer