HomeMy WebLinkAbout2014-00243 - water meter CITY OF ORONO
2750 KELLEY PARKWAY * 2 0 14 - 0 2 4 3
DATE ISSUED: 03/27/2014
ORONO,MN 55356-
(952) 249-4600 FAX: (952)249-4616
ADDRESS : 3590 NORTHERN AVE
PIN : 17-117-23-43-0138
LEGAL DESC WILEYS PARK LAKE MTKA
: LOT 008 BLOCK 002
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
NEPTUNE#1831526508
WATER METER RESIDENTIAL HORN 1 WATER METER RESIDENTIAL 1
APPLICANT WATER METER RESIDENTIAL 303.70
WATER METER RESIDENTIAL HORN 86.64
MAENNER,BRADLEY&AMANDA TOTAL 390.34
2130 TAMARACK
LONG LAKE,MN 55356- Payment(s)
CHECK 3128 390.34
OWNER
MAENNER,BRADLEY&AMANDA
2130 TAMARACK
LONG LAKE,MN 55356-
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 governing 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 the date of issuance,or if construction is
suspended for a period of 180 days at antime after work has commenced.
The applicant is responsible for assuring 1 required inspections are
requested in conformance with the State Puilding Code.This permit may be
revoked at any time fo se.
3 t�
Applicant Permitee Signature Date i-ssued'liy S' Lure Date
FOR CITY USE ONLY
City Orono
P.O.Box
66 Date Received: Permit#
2750 Kelley Parkway
Crystal Bay,MN 55323 Approved By:(If Required):
(952)249-4600
`AkESHO �G CITY OF ORONO-WATER METER FORM
( Note:Some permits may require approval by the Building Official and/or Public Works Department
GENERAL INFORMATION
1. WATER METERS must be picked up and paid for at City Hall.
2. Ifosp sible,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 meter installation.
TYPE OF PERMIT
Check All That Apply)'.
[residential(May Require Approval) ElCommercial(Approval Required)
/❑New Meter ❑Additional Meter—For: Replacement Meter
Job Site/Owner Information:
Site Address: 359® N10k- i FdW y t 09=42 I
Owner:t(Z U Mailing Address: 5590
City: ®IZori t Zip:
Home Phone: (0Og'335-1 Z7 S Alternate Phone:
Contractor Information:
Contractor: Contact Person:
Address: State License#:
City: Zip: Expiration Date:
Phone: Alternate Phone:
s r
❑ 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: /t�o
SIZE: ❑5/8" 163/4" ❑ l" ❑Other 59
SERIAL#: 11111111E1111u1111111111M
1831526588
ERT HIGH#: (if applicable)
ADDITIONAL,INFORMATION-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 wit the ordinances of the City and the regulations of the State
of Minnesota, and certifies th t all stat ents made on this application are,true and correct.
Applicant: Date: 3/2-7/4
Original: I-Address File
Make Copies For: I- Utility Billing Department 1-Cash Drawer