HomeMy WebLinkAbout2013-00699 - water meter ` � CITY OF ORONO * 2 0 1 3 - 0 0 6 9 9 *
2750 KELLEY PARKWAY DATE ISSUED: 07/23/2013
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2789 PHEASANT RD
PIN : 21-117-23-32-0005
LEGAL DESC : REG.LAND SURVEY NO. 0310
: LOT 000 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)249-46
NEPTUNE I"WATER METER&HORNS
SERIAL NUMBER-52648047
ERT HIGH# 1834347428
WATER METER RESIDENTIAL HORN 1 WATER METER RESIDENTIAL 1
APPLICANT WATER METER RESIDENTIAL 392.92
STEWART PLUMBING,INC. WATER METER RESIDENTIAL HORN 104.45
13025 GEORGE WEBER DR
SUITE#1 TOTAL 49737
ROGERS,MN 55374 PAID WITH CC# 3122
(763)428-1833
OWNER
TEYNOR,GAIL&JOSEPH
13225 CARDINAL CREEK RD
EDEN PRAIRIE,MN 55346-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be perfortned 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 wi(I
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 aze
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
�'- - .6�� � � (� 7 � �, ,C3
Applicant Permit e Signature Date Issue y Signature Date
�, SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
Jul 23 13 08:39a Stewart Plumbing Inc. 763-428-1733 p.1
. ,
FO�L;SE ONLY � %/
O City of Orono ry�/�,
� �O P.O.Box 6C+ Date Receive Pem�it N��t,L�/,%
2750 Ke11ey Parkway
Crystal Bay,MN 55323 Apprmed By:(Tf Required):
(952}249-d6Q0
l t�, ,�
�� CITY OF ORONQ–WATER METER FORM
l�K�SH��� *Note:Some
( permits may requirie approvel by tbe Suiiding Oflicial aid/or Public\Vorlcs Department
ti�
GENERAL iNFORMATION
1. WATER METERS must be picked up and paid for at City Halt.
2. If possible,fax in this application ahead of time;we wip then call you and let you know we have
the water meter in stock. Fax Number.�952)249-4616_ Also,you can ca11 ahead o€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 Oroao Water Department (952) 249-4600,
upon completzon of ineter installatioe.
TYPE OF PERMIT
Check All That A lv
�,Residentia[(May Require Approvat) ❑Commercial(Approval Required)
�New Meter ❑ .qdditional Metec—Por: ❑Replacement Meter
Job Site/Ovut�er Informaiion:
i: � J '
S ite Address: ��� � ���')!"G;..��1�C� j�C�.
I
Owner: r�,s� -1-: ;;i�;r�l� ��i;u� Mailing Address:
��—' �
City: Zip:
Home Phone: Alternate Phone:
Contractor information:
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Contractor: .� �l-�i�-t ���.«.1,1�:;�:� Contact Person: ��,r;��.-��� ;-1A,�'�nu'(
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.
Address: �^�S� (�.�{'������j;.r`.kr:r �D�. State Licensc#: C�(r,l,�t�m1
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City: `C'� Zip:. ,37�{ Expiration Date: 1.;�:�3� '�`t
Phone: %(�.3- `--�)_�'���� Altemate�hone:
Jul 2313 08:39a Stewart Plumbing Inc. 763-428-1733 p.2
WATER METER PERMIT FEES
WILL BE CAtlLUI..ATED BY C1TY STAFF
❑ 5;8"h4ETER- ❑ 3/4"MBTER- '�} 1"hfETER-
❑ 5/8"HORN - � 3/4"HORN - � 1"HORi� -
[] "W�1TER NETER (THESE W[A,L HAV E TO BE SPECL4L ORDERED&YRICES D�TERMl1YED)
1. METER FEE: �
2. NORN FEE $
3. TOTAI,PERM[T FEE(Add Lines 1-2 Above) S `T�7� !
��E'GSi ��L��` �r� C1'1=d,�- ��Cr.�l.�t
CITY-USE ONLY
'•` For Current Pricing Refer to Current Year- Water Meter Pricing Chart *
BRAND: ����
S[ZE: ❑5!8" 0 3/4" [�7" ❑Other "
SERiAL#: ���P � p O �7
ERT HIGH#: I 0 ��3 � 7 T� 0 �����������������������������
(ifapplicable) 1834341428
ADDITIONAL INFORMATION— WATER METERS
The undersigned hereby applies to the City of Orono for issuance af a water meEer 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 ti�at all sta.tements made on this application are,tnie and correct.
_ ��� 1
Appiicant: , , �'c.;- '�-,1%CL•��^u' Date: 7-.�.���_3
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Original� 1-AddressFile
Make Copees For: !-Utility Billing Department I-Cash Drmver
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CITY OF ORONO � 'J
serviceOrderNumbsr 824
SERVICE ADDRE33 DUE DATE: ����5
��'���+l '�"=�-L S�„ �* APPT TIME: p?9 5 /!7
CUSTOMER ���� ,.� f BILLlNG HOME PHONE: �-L��0.�,��
BILLING WORK PHONE:
ACCOUNT NUMBER BOOK/STOP:
DATE/TIME CREATED CALL 7AKEN BY:
.. — - — . .i
Requesmd By:
NATl1RE OF WORK ORDER --
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Ftnal Bflling Address(Info):Forwarding Address New Customer Informatlon:
Address: Name:
. .. _ _ _ __. _
City: Maiiing Address: _ __ -_ _ ..
__.__._�..._ ._.._.__.__ ___ __.__.___. . _ _._....
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State:
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Z�P� Phone:
READING INFORMATION Service Number: ��water zo4ueduct�v
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CURREM'METER SIZE MAKE SER(AL NUMBER LAST READlNQ DATE
service Numeer: pa��n�E��; ERT ID LAST METER READING
10 �
CURRENT READING
METER REMOVED $�E �� � SERIAL NUMBER CURRENT READING
I NEPTUNE f �a� y�o �-% 7
Sanriea Number. l� � ERT ID �������5 �z
10 1 ❑ Irnerrtory � / ��Y��'l7�(d"� �
� � Jvnked U
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METER INSTALLED g� MAKE � SERtAL NUMBER NEW STARTING REAO
ServE�e Num6er: DetB IqSt8118d. I ERT 1D _ _
I,� Dedud Meter
_.._.___.____- _ _ : _. __. _.._ __. _. _ _.___ ,_ _. .__ �
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