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HomeMy WebLinkAbout2016-01118 - water meter � - CITY OF ORONO * z 0 1 6 - 0 1 1 1 8 * 2750 KELLEY PARKWAY DATE ISSUED: 09/15/2016 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 656 SANDSTONE CIR PIN : 33-118-23-11-0054 LEGAL DESC : STONEBAY : LOT 005 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#53591579 ERT HIGH# 1541607936 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 516J0 (763)497-7486 Minnesota State License#:plbg-PC643806,mech-MB004099 OWNER Essay Holdings 2110 LYNDALE AVE S MINNEAPOLIS,MN 55405-2 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 nuil 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 l80 days at any time afrer 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. t, , : �f' fS ��� � -�� � �� �Si � � lic t PGimiF ignature Date Issued Signature Date R ITY SE ONLY ,�O A T City of Orono ��J �/ �y P.O.Box 66 DateReceivedJ �..5 rmit#!��yc v��- b�/ � (J � 2750 Kelley Parkway Crystal Bay,MN 55323 Agproved By:(It'Rcquired): (952)249-4600 �F�-sxF o���'� CITY OF ORONO—WATER METER FORM S H (Note:Some permits may require approval by the Building Official and/or Public Works Department) GENERAL 1NFORMATION 1. WATER METERS must be picked up and paid for at City Hall. 2. If 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 OF PERMIT Check All That A 1 � Residential(May Require Approval) ❑ Commercial(Approval Required) ew Meter ❑Addrtional Meter—For: ❑ Replacement Meter b Site/Owner Informatian: Site Address: ��� C����� Owner: ��� ����2-- Mailing Address: City: ���� Zip: Home Phone: Alternate Phone: Contractflr Information: Contractor: ���u� �� ��Contact Person: �vt 5 Address: �-{.�c9�( (NICi�.�a�.� C�. State License #: ����( �� City: ����"� ZipS�3��Expiration Date: Phone: �� Alternate Phone: ���P 3 �y�7�� ��(�o �.; n�y�'.�. � � ��K k��,, ��� . A- S�;;� }.;�.. F�� _5 ❑ 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 � » i.. S�: ❑5/8" ❑3/4" ❑ 1" ❑�eT 53591579 SE�.�,L#: IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII ERT HIGH#: 1541607936 (�f applicable) AD�iTi�3dAL iNFO�MIATI�3�i—�A'TE�I�ETEI�S 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 all statements made on this application are,true and correct. _� ��% Applicant: Date: � Original: 1-Address File Make Copies For: 1- Utility Billing Department ✓ DATE TIME CITY OF ORONO CALLED IN INSPECTION NOTICE t, SCHEDULED �� �Pev� PERMIT NO.���' O��O'b�� I d COMPLETED �, ADDRESS �-`S� S�IJ c�S�� ���c I� �NNER * � TELEPHONE NO� CONTRACTOR �r"eGS r e�� D l v/�'1 6/n q � DESCRIPTION Se'T"���"l ���`�' Ly ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING �Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP i ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL v ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 OWNERICONTRACTOR TO MEET V�U:_YES_NO � COMMENTS: 4 j 0 � ��� 0 W � � f �' ri4-cl� !I 4 /S ���5��� ln Z W � Z��f� �� ���,07 93� � W .�`INORK SATI,SFACTORY:PROCEED r-�.�ECT COMPLETE ��O CORRECT WORK d�PROCEED �O ISSUE CERTIFlCATE OF OCCUPANCY 0 ❑CORRECT WORK����R REINSPECTION TEMPORARY V BEFORECdI/ERING PERMANENT O COFiRECT UNSAFE CONDITION WRHIN HOUHS. p pF{OTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR ��TATION ISSUED O INSPECTION REW�RED.CALL TO ARRANGE ACCESS. CaN tor the next inspectron 2�t taurs in advance. (952) 249-4600 OwnerlContractor on site: Inspector: Whit�CopyAnspector's FlI� C�nary CopylSfte Notke