HomeMy WebLinkAbout2012-01183 - water meter " ' ` CITY OF ORONO
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, 2750 KELLEY PARKWAY �ATE �SSUE�: 11/19/2012
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2365 GLENDALE COVE LA
PIN : 34-118-23-33-0068
LEGAL BESC : GLENDALE COVE
: LOT 009 BLOCK 001
PERMIT TYPE : PLUMBING (>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER METER- RESIDENTIAL
WATER METER IRR[GATION HORN 0 WATER METER IRRIGATION 0
WATER METER RESIDENTIAL HORN 1 WATER METER RESIDENTIAL 1
APPLICANT WATER METER RESIDENTIAL 303.70
GENZ-RYAN PLUMBING& HEAT WATER METER RESIDENTIAL HORN 86.64
2200 HIGHWAY 13
BURNSVILLE, MN 55337 WATER METER IRRIGATION 0.00
(952)767-1000 WATER METER IRRIGATION HORN 0.00
TOTAL 390.34
PAID WITH CC# 1556
OWNER
BARNIER, STEVEN P
2365 GLENDALE COVE LN
LONG LAKE, MN 55356-
AGREEMENT AND SWORN STATEMENT
fhe work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State[3uilding Code. This pemiit is for only the work described and docs
not grant permission for additional or related work which requires scparate
pennits. All provisions of laws and ordinances governing this typc of work
shall be compied with whether or not specitied herein."�his 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 time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
/ / / /
Applicant Permitee Signature Date Issued By ' nature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB .
Fro��:Gen�Ryan 952 767 1900 11 /19/2012 12:21 #773 P.0021003
: F�R'C1TY USE'nNLY '
O���O City of Orono '
P.O.Box 66 Date Reaeived- Permit#
i �,�,,. 2750 Kelley Parkway
� � t Crystal Bay,MN 55323 A�.soved By_(If Requixed):,
?L� '�6` (952)249-4600
�
CITY OF ORONO—WATER METER FORM
(*Note:Some permirs may require approval by ihe Building Official and/or Pubiic Works Depamnent*)
: ;
GENERAL IN�QR�v1A'�ION . .. . :; ; ; , :
1. WATER METERS must be picked up and paid for ai City Hall.
2. If�ossible,fa�c in this application ahead of timc; wc wifl thcn caU 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;C�F�ERMIT �� - '� � . � ���� �.: :: ;
Check All That A 1 _ "' `
�Zesidential (May Require Approval) ❑Commercial(Approval Required)
�New Meter ❑Additional Metcr—For: �Rcplacement Meter
7ob.Site I Owner Informatiori '
Site Address: . 2-� �� �� ��'�'��'�- ��v� �,���
.i-ti-y ' �22� �� �\v c�
Owner:�✓� ,1�'- �a�`�� Mailing Address:
City: �� 1 �,� Zip: ��d�'
Home Phone: Alternate Phone: ��1�2 '���'
-Contractor Information. . "' `
Contractor: �1 Contact Person� ��� �'� �S� '��
Address: 2� C�`�"y ,� � State License#: ��� �/�i ` ��
City: �U r��� �t� Zip:s�33 �] Expiration Date:
Phone: C°�c✓Z1��0�" I�CJ� Alternate Phone�
From.,:Genz�Ryan 952 767 1900 11 /19/2012 12 :21 #773 P.003/003
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❑ �/8"METER- � 3/4"METER- � 1"METER-
❑ �/8"HORN - 3/4"HORN - � l"HORN -
❑ "WATER METER (TIIESE WILL HAVE TO BF.SPECfAL ORDERED&PRICES llETERM11�iF.D)
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1. MFTER FEE: $ �� • � �
2. HORN FEE $�_._lfl�� 4
,
3. TOTAL PERMIT FEE(Add Lines 1-2 Above) �
CITY-USE ONLY
* Fpr Current Pricing Refer to Current Year- Water Meter Pricing Chart *
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BRAND: _
SIZE: ❑5/8" �3/4" ❑ 1" ❑Other "
S��AL�: — III III III III II II IIII I II III III -
1832390008
ERT HIGH#: _ (if applicable)
' ,�' ADIDITI[3NAL'1NF.OR1ViATION:—:WATER ME'I`ERS : ' `
The undersigned hereby applies to the City of Orono for issuance of a water meter permit, agrees
to do all work in strict accordance with the ordinances of the City and the regulations of the State
of Minnesota,and certifies that all statements made on this application are,true and conect.
Applicant: Date: �O �
: �#teset Farm
Original: 1-Address File
Moke Copies Fnr: 1- Utility$illing Depa�-tment !-Ca.rh 17rawer