HomeMy WebLinkAbout2016-01119 - water meter - CITY OF ORONO * z 0 1 6 - 0 1 1 1 9 *
2750 KELLEY PARKWAY DATE ISSUED: 09/15/2016
� ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 658 SANDSTONE CIR
PIN : 33-118-23-11-0055
LEGAL DESC : STONEBAY
: LOT 006 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#53713914
ERT HIGH# 1542129104
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 516J0
4124 MACKENZIE CT
ST.MICHEAL, MN 55376 Payment(s)
(763)497-7486 CREDIT CARD 9766 516.70
Minnesota State License#: plbg-PC643806,mech-MB004099
OWNER
Essay Holdings
2110 LI'NDALE 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 rype 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 time for due cause.
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Applic�nt Perrmtte Signature Date Issued B ignature Date
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F R CI ' USE ONLY
O City of Orono 9 �j
�- � P.O.Box 66 Date ReceiJ� _,�Permit# b/(p —O /I l /
� 2750 Kelley Parkway
Crystal Bay,MN 55323 Approved By:(Ifitequiredj:
(952)249-4600
���-s,�E o���'� CITY OF ORONO—WATER METER FORM
S H (riote: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. F�Number:(952)249-46]6. 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
Checic All That A 1
�sidential(May Require Approval) ❑ Commercial(Approval Required)
�ew Meter ❑Additional Meter—For:
❑Replacement Meter
Job Site/Qwn�r information:
Site Address: ��
Owner:�� ��'�'(z._ Mailing Address:
City: ��=s✓IW Zip:
Home Phone: Alternate Phone:
Contractor Information:
Contractor: �;��y�j� ��, Contact Person: _�L� S
Address: �-E1,�-� ��"�u� C.�- State License#: �t�2�-�� C��ti'�
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City: +� Zip:j�� Expiration Date:
Phone: �" Alternate Phone: �7(�3�'�-�(�--7�:�
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❑ 5/8"METER- ❑ 3/4"METER- 1„METER-
❑ 5!8"HORN - ❑ 3/4"HORN - "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 *
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SIZE: ❑ 5/8" ❑3/4" ❑ 1" ❑Other " 53713914 IIIIIIIIIIII
SE�L#: IIINIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII
ERT HIGH#: �������MNa���r0°° (if applicable)
1542129104
AD�iT�O3�I�1I..iAiF�D�AT'�03�-@VA'T��.�ETETLS
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: � � �r
Original: 1-Address File
Make Copies For: 1- Utility Billing Department
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED /�--� �
PERMIT NO. ���-����� MPLETED
ADDRESS ��1� �������--e �/�C�.�
OWNER � TELEP E NO. �� Z ��C9-5�`r�
CONTRACTOR �-� ��u� y�dl`
� DESCRIPTION ry`�`- "—v
t~11 ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
� ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
� ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
_ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
v ❑ DEMO-SITE ❑ SEPTIC INSTALL
Z OWNERICOI�fTRACTOR TO MEET YiOU:_YES_NO � ,� Q_
� COMMENTS: �C,K—[,?��L. " I �J 1,00
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W rf�VORKSATISFACTORY:PROCEED � MPLEfE
W �CORRECT WORK 6 PROCEED � ❑ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECTVYORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECONERING PERMANENT/�
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN ��� �
INSPECTOR WILL RETURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REWIRED.CALL TO ARRANGE ACCESS. /
Call for the next inspectf 2a hours in advance. (952) 249-46��
OMrnerlCorttractor on site: '
Inspector: � c-���
White CopyAnspector's Flle Cenary CopylSite Notke