HomeMy WebLinkAbout2018-00239 - water meter CITY OF ORONO I I I I I 11 Ilan�I I IE11 � ID �
2750 KELLEY PARKWAY DATE ISSUED: 03/02/2018
ORONO,MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2265 BAYVIEW PL
PIN : 17-117-23-44-0030
LEGAL DESC : WALLACES ADDN TO VIL OF MTKA B
: LOT 028 BLOCK 000
PERMIT TYPE : WATER METER-RESIDENTIAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER METER HORN
NOTE: 5/8"METER HORN
WATER METER RESIDENTIAL HORN 1
APPLICANT WATER METER RESIDENTIAL HORN 82.02
TOTAL 82.02
API Payment(s)
307 JACKSON AVE#4 CREDIT CARD 1632 82.02
ELK RIVER,MN 55330-
(612)290-8959
OWNER
HATTARA,LAUREN
2265 BAYVIEW PL
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 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 any time after work has commenced.
The applicant is responsible for. suring all required inspections are
requested in conforma,ce wi ji.- tate Building Code.This permit may be
revoked at any tim- .r. .aus
2-4. G , o--,/0
Appli. t Permitee Signature Date Issued :e.ignature Date
�T City of Orono / i# ONLY
WPOBox66 Date v+72750 Kelley Parkway
Crystal Bay,MN 55323 By:( itequire d):
(952)249-4600
o4CITY OF ORONO-WATER METER FORM i SA`O
SH (Note:Some
(N 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. 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 meter installation.
TYPE OF PERMIT
(Check All That Apply)
0 Residential(May Require Approval) ❑ Commercial(Approval Required)
0 New Meter D Additional Meter—For: 0 Replacement Meter
Job Site/Owner Information:
Site Address: - kV9,1/"Ice,) t/
Owner: v12Cry l i;6->za Mailing Address: 22 - yr ('(
City: CLx`ro Zip: 5-73 5
Home Phone: Z/2---2 o Y23? Alternate Phone:
Contractor Information:
if
Contractor: !l -� Contact Person: - "' t `?
Address: ►"mc'ti /tate License#: GCZS.--? -/ 7/4
City: a-�-IiC7 Zip:5 33 Expiration Date: 12-/3(/ii
Phone: g/2 - 2YU ^�5' Alternate Phone: &Z _28O-MA
'1 METER ?` rii . _ ,4: "
x
❑ 5/8"METER- 0 3/4"METER- ❑ 1"METER-
(5e5/8„HORN - 0 3/4"HORN - ❑ 1"HORN -
El "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:
SIZE: 0 5/8" 0 3/4" 0 1" 0 Other ')
SERIAL#:
ERT HIGH#: (if applicable)
ADDITIONAL INFORMATION—WATER METERS I
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 :.t all s ments made on this application are,true and correct.
3/ZAF
Applicant: / Date:
i
l
Original: 1-Address File
Make Copies For: 1- Utility Billing Department