HomeMy WebLinkAbout2012-00299 - water meter '"' "' CITY OF ORONO
` 2750 KELLEY PARKWAY * � 0 1 2 - PJ 0 2 9 9 *
DATE ISSUED: 04/19/2012
� ORONO,MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS : 70 MYRTLEWOOD RD
PIN : 36-118-23-33-0018
LEGAL DESC : REG.LAND SURVEY NO.0446
: LOT 000 BLOCK 000
PERMIT TYPE : WATER METER
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER METER
NOTE: 1NSEPCTIONS ARE DONE BY PUBLIC WORKS DEPARTMENT.
TO SET-UP AN INSPECTION,PLEASE CALL:(952)249-4613
WATER METER RESIDENTIAL HORN 1 WATER METER RESIDENTIAL 1
APPLICANT WATER METER RESIDENTIAL 245.70
6 CARSON CONTRACTING WATER METER RESIDENTIAL HORN 68.97
4410 TOTAL 314.67
OAKDALE,MN 55128-
(651)770-2338
OWNER
SWANSON,JOSEPH
70 MYRTLEWOOD RD
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 additional or related work which requires separate
permits. All provisions of laws and ordinances goveming 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 th date of issuance,or if construction is
suspended for a period of 180 at any time after work has commenced.
The applicant is responsibl o suring all required inspections are
requested in confo anc i the State Building Code.This permit may be
revoked at an t' fo u cause.
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Applic P ' e Signature Date Issued By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
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CTTY OF ORONO-WATER METER FORM
(•]Vote:Some pe�mils may iequi:e approval by the Buikiing Officfel sndlor Pubiic Works Deparunent•)
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1. WATER METERS tnust be pickaci up and paid for st City Hail, '
2. j�lg fax in this spplic�tion ahead of time;we will then call you anti lat you know we havc '
tbe water meter in st�k. Fax Number:(452}7�49-4b 16. Also,you can calI ahead of dme to make
. sure we recaivad the fax,ar to warn us that the fa�c is coming. !
3. WATER MET�RS mnst be set and eeale@ by Orono Wate'r Department(9�2) 249-�4600, `
upoa completton of ineter lastall�tioa
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�Atew Meter ❑Additional Meter—For: �Rcplacemmt Metec
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Contractor: �1���h C��'L'�Contact Person: �ll�
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City: D'���G Zip:� Expiration Date:
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Phone: ,�3'7• 7 7 � L33Y Alternate Phone: �Z �� � � 7�`1
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5i8"METER- ❑ 314"METBR- - [,� t'>MET'ER-
5/S"HORN - ❑ 3/4"HORN - ❑ I"HORN -
❑ "WATER METER (THESE WILL HAVE TO BE SPECIAL Ol2DERED&PRICES DETERMTNPA)
1. METER FEE; $ �( �D.
2. HU�N 1�BS $ �()�f ..C� �
• 3. TOTAL PERMIT FEE{Add Lines 1-2 Above) $
cz�-u�� o:rrLY
* For Current Pricing Refer to Current Year-Water Meter Pricing Chart*
BRAND: _ �U��
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S��AL#: III IIIlI IIII IIII I I III!II I!!!!
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ERT HIGH#: (if appaicabJ.e)
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The undersigned hezeby applies to the City of Orono for issuance of a water meter permit,agrees
to do atl work in strict rdance with the ordinances of the City and t�e regulatious of the Staf.e
of Minnesota,and cer ' s that all s�ta.tements nn.a.de on this applicatian are,true and correct.
Applicant: � Date:
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Original: 1-.4ddress Fite
Make Capies For: 1-Utility Bilding De1vrrrtmeni I-Cash Drawer