HomeMy WebLinkAbout2013-01102 - water meter III
CITY OF ORONO
* 20 1 3 - 0 1 1 02 *
2750 KELLEY PARKWAY DATE ISSUED: 10/21/2013
ORONO, MN 55356-
(952)249-4600 FAX: (952)249-4616
ADDRESS : 2339 OLIVE AVE
PIN : 17-117-23-44-0075
LEGAL DESC : WILEYS NAVARRE ADDN LAKE MTKA
: LOT 017 BLOCK 000
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-3/4"WATER METER-SERIAL#52680829
ERT HIGH# 1834496268
WATER METER RESIDENTIAL HORN 1 WATER METER RESIDENTIAL 1
APPLICANT WATER METER RESIDENTIAL 303.70
NORTH ANOKA PLUMBING WATER METER RESIDENTIAL HORN 86.64
22590 RUM RIVER BLVD.N.W.
MN 55070- TOTAL 390.34
(763)753-3373
OWNER
Bamboo Properties LLC
1171 NORTHLAND DR
#100
MENDOTA HEIGHTS,MN 55120-
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 assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any tim for due cause.
_ _� f )1 X21 /J�
Ap cant Perm ee Signature Date Issu=ll:y Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
1 At
F R Y USE ONLY
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0A T City of Orono c Q 1 1, Permit# /3-0//04 .....'"-
*
PO.Box 66 Date Re � e '
2750 Kelley Parkway
Crystal Bay,MN 55323 Approved By:(If Required):
(952)249-4600
'�t SHO� 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. 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)
Residential(May Require Approval) ❑ Commercial(Approval Required)
Z'New Meter ❑Additional Meter—For: ❑ Replacement Meter
Job Site/Owner Information:
Site Address: c-) 3 3 1 0 V4.4)-e._
Owner: Pte. kl-C Mailing Address: 1/7I gy2(hL
106
City: ■, c_ i ; Zip: 5 S/aO
I
Home Phone: Alternate Phone:
Contractor Information:
Contractor: AjKA, Contact Person: a
Address: c a State License#: G 5C13j,/ - PP1
City: VJv4 4L L. Zip: // Expiration Date: )1-31-X13
Phone: 763— 753-33 73 Alternate Phone:
� d, r 1 $i m 6 6 F I i #"aim a *.� � � ry$arx rr
¢p
z kwr. a ''z -, #ar r* Y+,? �"' 4. ? .
4(z- jer
❑ 5/8"METER- Or 4"METER- ❑ 1"METER-
❑ 5/8"HORN - 14 /4"HORN - ❑ 1"HORN -
El "WATER METER (THESE WILL HAVE TO BE SPECIAL ORDERED&PRICES DETERMINED)
1. METER FEE: $ 3 7 C
2. HORN FEE $ - . (P
3. TOTAL PERMIT FEE(Add Lines 1-2 Above) $ — 0 •
CITY-USE ONLY
* For Current Pricing Refer to Current Year- Water Meter Pricing Chart *
BRAND: /' 1-1A.471
SIZE: ❑ 5/8" K1 3/4" ❑ 1" ❑ Other "
SERIAL#: 5 A4070 g'
ERT HIGH#: III III IIII II II II III III I III III (if applicable)
1834496268
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 with the ordinances of the City and the regulations of the State
of Minnesota, and certifies that .11 statements made on this application are,true and correct.
Applicant: If p Date:/D'-o? 1
Original: 1-Address File
Make Copies For: 1- Utility Billing Department 1-Cash Drawer