HomeMy WebLinkAbout2008-00309 - water meter • .
CITY OF ORONO PERMIT NO.: 2oos-oo3o9
2750 KELLEY PARKWAY
ORONO,MN 55356- DATE ISSUED: 10/20/2008
952 249-4600 FAX: 952 249-4616
ADDRESS : 3477 LYRIC AVE
PIN : 17-117-23-43-0156
LEGAL DESC : N/A
: LOT 000 BLOCK 006
PERMIT TYPE : WATER METER
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER METER
NOTE: INSEPCTIONS ARE DONE BY PUBLIC WORKS DEPARTMENT.
TO SET-UP AN INSPECTION,PLEASE CALL:(952)249-4613
METER-NEPTiJNE 51002171 - 1810248110
WATER METER RESIDENTIAL HORN 1 WATER METER RESIDENTIAL 1
APPLICANT WATER METER RESIDENTIAL 312.40
SCOTT,LYLE&JOYCE WATER METER RESIDENTIAL HORN 61.00
2508 BANTAS POINT LA
MINNETONKA,MN 55391 TOTAL 373.40
OWNER
SCOTT,LYLE&JOYCE
2508 BANTAS POINT LA
MINNETONKA,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 dces
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 with whether or not specified herein.This permit will
expire and become null and void if consVuction authorized is not
commenced within 180 days of th date of issuance,or if construction is
suspended for a period of 180 da at any time after work has commenced.
T'he applicant is responsible for suring all required inspections aze
requested in conformance with e St te Building Code.This permit may be
revoked at me for due e
� l l�� � /V / L/ /V�
i ermitee Signature Date Issu y Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
� . .
' FQR CITY USE E}NLY
O¢��O City of Orono '
P.O.Box 66 Date Receiv�d: Pe�rrri�#
` 2750 Kelley Parkway
� � ,,. � Crystal Bay,MN 55323 Approved By:(If Required):
��s� (952)249-4600
CITY OF ORONO—WATER METER FORM
(*Note:Some permits may require approval by the Building Official and/or Public Works Department')
GENERAL INF(JRMATION '
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'PERMZT ;
(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: 3�1� l—.�L' �,\�, �p�l�
Owner: Mailing Address:
City: (��D� Zip:
Home Phone:�sa �1� �a-�� Alternate Phone:
Contraetor Information:
Contractor: Contact Person:
Address: State License#:
City: Zip: Expiration Date:
Phone: Alternate Phone:
. ,
:
.
❑ 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&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: ���`�(,h��
SIZE: ❑ 5/8" �3/4" ❑ 1" ❑ Other "
SERIAL#: SJ o O oZ/ '7�
III III IIII I IIII II I IIII III I III
ERT HIGH#: _ ig�p2qg�1p (if applicable)
ADDITTONAL TNFORMATION—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.
Applicant: Date:
Original: 1-Address File
Make Copies For: 1- Utility Billing Department 1-Cash Drawer