HomeMy WebLinkAbout2015-00412 - water meter � � • CITY OF ORONO
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2750 KELLEY PARKWAY DATE ISSUED: 04/10/2015
ORONO, MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS : 3484 LYRIC AVE
PIN : 17-117-23-43-0157
LEGAL DESC : NAVARRE HEIGHTS
: LOT MB BLOCK 5
PERMIT TYPE : WATER METER-RESIDENTIAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER METER-RESIDENTIAL
NOTE: INSEPCTIONS ARE DONE BY PUBLIC WORKS DEPARTMENT.
TO SET-UP AN INSPECTION,PLEASE CALL:(952)249-4613
3/4"WATER METER
SERIAL#53314731
ERT HIGH# 1852895951
WATER METER RESIDENTIAL HORN 1 WATER METER RESIDENTIAL 1
APPLICANT WATER METER RESIDENTIAL 294.42
WATER METER RESIDENTIAL HORN 80.42
GRADY RESTORATION LLC TOTAL 374.84
760 APPLEGARDEN ROAD Payment(s)
MOLJND,MN 55364 CREDIT CARD 8740 374.84
(952)472-1576
Minnesota State License#: BUIL-BC653190
OWNER
Grady Restoration
760 APPLE GARDEN RD
MINNETRISTA,MN 55364
AGREEMENT AND SWORN STATEMEIVT
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 pertnit 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 nuli 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 y time for d cause.
� / �//
Ap ant P rmitee Signa e Date Issued By Si nature Date
M � �
FUR CT!'I'iTS�iUM.X
City of Orono ' °
�ONO P.O.Box 66 I3ate Rec.�iveci: Perptit#
2750 Kelley Parkway
Crystal Bay,MN 55323 t4pptoved$y;(If Rcquired).
(952)249-4600
y ��
��kESki���G CITY OF ORONO-WATER METER FORM
(Note:Some permits may require approval by the Building Official and/or Public Works Department)
GE�RAL INFiJRMATi()N
1. WATER METERS must be picked up and paid for at City Hall.
2. If nossible,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 PERiVII�'
Ch�ck All Tlaat A 1 :
❑Residential(May Require Approval) ❑Commercial(Approval Required)
�New Meter ❑Additional Meter—For: ❑Replacement Meter
dpb Stte/fJwner Infarmativn:
Site Address: �_ `�7�7T Ul K-1� --��
Owner: ��_l/J .�I�1 Mailing Address: �l� �.l�D����
City: d�r0 ZiP: �7����
Home Phone: �7i�7T���(Z Alternate Phone: �(O� Z3� ��Z7
Contractc�r rnfc�rmatic�n:
Contractor: �-�'(.4�ontact Person: ��"t N
Address: ��p� /l.�P(1��'ll�+'l c�v State License#: `��o S�1 � D
City: ���� Zip: A�-/'� Expiration Date: ���� ���
Phone: � �. �,���Z� Alternate Phone: ��� � Z � s�
• , �.
❑ 5/8"METER- /4"METER- ❑ 1"METER-
❑ 5/8"HORN - /4"HORN - ❑ 1"HORN -
❑ "WATER METER ( ESE 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: NCf..
SIZE: ❑5/8" �3/4" ❑ 1" ❑Other "
SERIAL#: .��J��IjL73 �
ERT HIGH#: III III III III IIII IIIII II IIII II (if applicable)
1852895951
ADDITIt3NAL TNFORMATION=WA'TER 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: ' /� ' � S
Original: 1-Address File
Make Copies For: 1- Utility Billing Department