HomeMy WebLinkAbout2013-00624 - water meter CITY OF ORONO * Z 0 1 3 - PJ 0 6 2 4 *
2750 KELLEY PARKWAY DATE iSSUED: 07/09/2013
• , ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 3805 NORTH SHORE DR
PIN : 17-117-23-21-0029
LEGAL DESC : SHERRI LAKEVIEW ESTATES
; LOT 002 BLOCK 001
PERMIT TYPE : WATER METER-RESIDENTIAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER METER-RESIDENTIAL
NOTE: INSEPCTIONS ARE DONE BY PU[3I,IC WORKS Df�,PARTMGNT.
TO SE"T-UP AN INSPF.CT[ON,PLE�ISG CALL:(952)249-4613
5/8" WATER METER
SERIAL NUMF3ER-93297733
ERT HIGH- 1834805213
WATER METER RESIDENTIAL HORN 1 WATER METER RESIDENTIAL I
APPLICANT WATER METER RESIDENTIAL 245.70
SABRE HEATING & A1R COND INC. WATER METER RESIDENTIAL HORN 68.97
15535 MEDINA ROAD
PLYMOUTH, MN 55447 TOTAL 314.67
(763)473-2267
OWNER
RACHEL, DON
3805 NORTH SHORE DR
MOUND, MN 55364-
AGREEMENT AND SWORN STATEMENT
The work fbr which this permit is issued shall be performed according to
the approved plans and specitications,applicable City approvals,and the
State E3uilding 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 governing this type of work
shall be compied with whether or not specitied herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuancc,or if construction is
suspended for a period of I 80 days at any time after work has commenced.
The applicant is responsible Yor assuring all required inspections are
requested in conf rmance with the State Building Code.This permit may be
revoked at any ti for due cause.
C � � � � � � / /
Applica Permitee Signature Date Issue y Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
07/09/2013 TUE 8: 16 FAX 763 473 8565 Sabre Plumbing & Heatinq �001/002
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Cit•of Orono � �"' s t t�. �' /_7
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CITY OF ORONO–WATER METER FORM
(•Note:Somc pcnnits may n.quire approval 6y ihc Buiiding Ofticial and/or Pablic Works Dcpartmeni•)
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1. WATER METERS must be picked up and paid for ut Cify Hall.
2. lf possible,fax in this apptication al�ead of time;we will then ca11 you and lct you know we have
the water meter ir.stock. Tax Number:(952)219-4E16. Also,you car.call ahead af:ime to make
surc we received the fax,or to warn us that the faa is comina.
3. �VATEK METERS must be set and sealed by Orono Water bepartment (952) 249-4600,
upon completion of mctcr instailation.
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:.4 x..�a��'.'�.��':`,:�;�:S�:nL'�v�'".a�';�.�
Q�Besidential(May Require Approval) Q Commerciai(Approval Required)
Q'New Metcr �Additionat Meter—Eor: �Replacement Meter
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Site Address: ��t�i;`', �i��Y�-1.�.:::�4}c,��� �\ }�.` �
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Owner: Mailing Address:
City: Zip:
i-.o��..,�hone: A►`cernaie Phone: �
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__ ..___..__ . Contractor: �! �'�' � ���}':� Contact Person: ��Gl�1.tt�,v_-�------
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Address: !L �7�)!_) I�,Gf(��.t�fi .�..--1� State License#: �'�,(/��J,'��{-�j
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City: I;`� -�(^ ` � 7i ��:-�� Ex 1rat�on Date. ��- �)I-�(:%I_'�
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Phone: �ii)�'��'��l- L1_(�-'1 Alternate Phone: ��i���7`JJ 1�"j�,��'
07/09/2013 TUE 8: 17 FAX 763 473 8565 Sabre Plumbing & Heating �002/002
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(�5/8"MET�R- � 314"ME7'ER- ❑ 1"MCTCR-
(�''S/8"I�ORN - 3/4"HORN - ❑ 1"I-IORN -
❑ "WATER METER (THF.SB WILL HAVE 1'O[iF.SPEC(AL ORDERED&PRiCES DF.7'F.AMINF,D)
1. ME7'LR F��: g
2. ►iORN I�L'E g
3. TOTAL PERMIT FE�(Add Lincs 1-2 Above) � '�y�-�� �j~�
a y�+ �i < j�
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,� .SF.,
* For Current Pricing Refer Current Year-Water Meter Pricing Chart*
BRAND:
SIZE: �5/8" 3!4" ❑ 1" ❑Other "
S�RIAL#: 3�, 7 7 33
ERT HiGH#: p $Q�C�(� (if applicabEe)
The undersigned hereby applies to the Cily of Orono for issuance of a water meter pcm�it,agrees
to do al!work in s�rict accordance with the ordinances of the City and the regulations of the State
of Minnesota,and certifies that aIi statements made on this application are,true and correct.
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Appticant: _W�.�.(,Etl�:l, u��((,(;i�-L�'JL. -L�.. Date: �`�� Z.l.%i?,
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Original; 1-Address File
Make Copies For: 1-Uttli[y Bi!ling Deportmen� 1-Cash Drnwer