HomeMy WebLinkAbout2016-01117 - water meter � . .
CITY OF ORONO * 2 0 1 6 - 0 1 1 1 7 *
2750 KELLEY PARKWAY DATE ISSUED: 09/15/2016
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 654 SANDSTONE CIR
PIIY : 33-118-23-11-0053
LEGAL DESC : STONEBAY
: LOT 004 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
1"NEPTUNE WATER METER
SERIAL#53591584
ERT HIGH# 1541625820
WATER METER RESIDENTIAL HORN 1 WATER METER RESIDENTIAL 1
APPLICANT WATER METER RESIDENTIAL 372.06
WATER METER RESIDENTIAL HORN 144.64
PRECISION PLUMBING&HEATING INC. TOTAL 516.70
4124 MACKENZIE CT
ST. MICHEAL,MN 55376 Payment(s)
CREDIT CARD 9766 516.70
(763)497-7486
Minnesota State License#:plbg-PC643806,mech-MB004099
OWNER
Essay Holdings
2ll0 LYNDALE AVE S
MINNEAPOLIS,MN 55405-
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 l80 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 time for due cause.
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A 1 � ature Date Issued B ignature Date
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F'U CIT USE QN�Y
City of Orono �"
g-O� P.O.Box 66 Date Receiv��S_��permii#o�Z�/tp'� I� �
0 2750 Kelley Parkway
Crystal Bay,MN 55323 Approved By:(If I�equiced):
(952)249-4600
���q,�E o��.�� CITY OF ORONO-WATER METER FORM
S H (rlote:Some permits may require approval by the Buiiding Official and/or Public Works Department)
GENERAL INFORMATION
1. WATER METERS must be picked up and paid for at City Hall.
2. I�ossible, 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 ineter installation.
TYPE(3F PERMIT
Ch�cic All T'hat A 1
�esidential(May Require Approval) ❑Commercial(Approval Required)
New Meter ❑Additional Meter—For:
❑ Replacement Meter
Job Site/Oumer Information:
Site Address: �� � �(,�,�„t�
Owner: ( C��✓� OS���`Z Mailing Address:
City: ��Il�� Zip:
Home Phone: Alternate Phone:
Contractor Information:
Contractor: �f��PSIG�'� ��� -�� Contact Person: ��5
Address: �-{�}�( � ,v�2f2 �- State License #: ���� �(
City: �V�tr(/��e./I Zip:���PExpiration Date:
Phone: Alternate Phone: ��P3���"-���
• � i
SWATER ME'I'ER PE�h�1IT�'EES
�iLL BE CAULULATED BY CITY STA�F
❑ 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: ED2F11 RDG3 �
�..
SIZE: ❑ 5/8" ❑ 3/4" �1" ❑Other " I 535915 i�IIIIIIIIIIIIIIII
� I IIIIIIIIIIIIIIIIIIIIIIIIIIIIII,_I_
SERIAL#: —
ERT HIGH#: ��5�q�62�5820 (�f 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 with the ordinances of the City and the regulations of the State
of Minnesota, s that all statements made on this application are,true and correct.
._----___—_____ /
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Applicant Date:
Original: 1-Address File
Make Copies For: 1- Utility Billing Department
CITY OF ORONO CALLED IN Q�— A��/ 7 TIME
INSPECTION O E SCHEDULED — � R—� �
PERMIT NO. c M LETED
ADDRESS �
OWNER - TEL NE NO.
CONTRACTO
� DESCRIPTION � � �
W ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
� ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
Q ❑ FOUNDATION WATERPROOF�PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ R A D O N S L A B ❑ M E C H A N I C A L R I ❑ S I T E I N S P E C T I O N
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
i ❑ AS BUILT-SURVEY ❑ SEWEH HOOK-UP ❑ FOUNDATION/REMOVAL
v ❑ DEMO-SITE ❑ SEPTIC INSTALL
Q OlNNERICONrMCTOR TO MEET YiOU:_YES_NO
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� COMMENTS: /�.1/c� 1�/�'� l Z�7
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W ❑WOFiK SATISFACTORY:PROCEED ❑PROJECT COMPLETE
� ❑CORRECT WORK d�PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
W
O O CORRECT WORK����R REINSPECTION TEIdPORARY
V BEFORE COMERING PERMANENT
❑COFtRECTUNSAFECONDITiONWITHIN HOURS. O PHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ��TATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Catl for tl�e next inspection 24 hours in advance. (952) 249-4600
OwnerlCorrtraetor on site:
Inspector: ���''�'"��'"�__._ �'a G�J�y
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YVhite CopyAnspector's Flle C�nary CopylSib No1M�