HomeMy WebLinkAbout2016-00101 - water meter f S � CITY OF ORONO * 2 0 1 6 - 0 0 1 0 1 *
2750 KELLEY PARKWAY DATE ISSUED: 02/0112016
ORONO,MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 660 SANDSTONE CIR
PIN : 33-118-23-11-0056
LEGAL DESC : STONEBAY
: LOT 007 BLOCK 002
PERMIT TYPE : WATER METER-RESIDENTIAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER METER-RESIDENTIAL
NOTE: INSEPCTIONS ARE DONE BY PUBLIC WORKS DEPARTMENT.
"I'O SET-UP AN INSPECTION,PLEASE CALL:(952)249-4613
5/8"NEPTUNE WATER METER
SERIAL# 1540103274
ERT H[GH#68506712
WATER METER RESIDENTIAL HORN 1 WATER METER RESIDENTIAL 1
APPLICANT WATER METER RESIDENTIAL 242.65
WATER METER RESIDENTIAL HORN 82.02
PRECISION PLUMBING&HEATING INC. TOTAL 324.67
4124 MACKENZIE CT
ST. MICHEAL,MN 55376 Payment(s)
(763)497-7486 CREDIT CARD 7719 324.67
Minnesota State License#: plbg-PC643806,mech-MB004099
OWIYER
Stonebay Builders LLC
14870 BROCTON LANE
DAYTON, MN 55327-
AGREEMENT AND SWORN STATEME1vT
The work for which this permit is issued shall be performed according to
[he 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 l80 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. �
.� F� -/� ��l �v � � 4� � Gb
icant ermitee� ignature Date Issued B 'gnature Date
i � �
�t I�E O��WLi' '
City of Orono /�
�� P.O.Box 66 I3a�c R�i f,�� P+�at#.(��,� (/�
� 2750 Kelley Parkway ��
Crystal Bay,MN 55323 A�d T�y:(�'R,Fqttit�d�: '
(952)249-4600
�`��q �,�� CITY OF ORONO—WATER METER FORM
kESH�R ote:Some rmits ma re uire roval b the Buildin Official and/or Public Works
� Pe Y 9 ePp Y S Department)
GENERAL TNFO�TIOi�T
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 Irnow we have
the water meter in stock. Fax Number:(952)249-4616. Also,you can call ahead of time to make
swe 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.
���P�`�
�#CG�A���t f�
(�Residential(May Require Approval) ❑Commercial(Approval Required)
�,New Meter ❑Additional Meter—For: ❑Replacement Meter
Joi�S��e/Owner It'�'o�a:a�tit�:
/' .. ,r�
Site Address: � J�� ��dt� (
Owner: Mailing Address:
City: Zip:
Home Phone: Alternate Phone:
Co��t�I��rm����:
�n. �
Contractor: ��c�5.6a ����� } �/�t�ontact Person: /"I '�
Address: ��� !�'�c�.?.�_ ��{J�State License#: �C �4�gC'7�
City: ��'+j�k�-� Zip�S39G Expiration Date: !a'3�^j �
Phone: l76�^�{cl7—?1.��� Alternate Phone: 7�v3'�R'?^7S(g''G
'� � i
WATER METER PERMIT FEES
WILL BE CAULUL�TED BY CITY STAFF
�/8"METER- ❑ 3/4"METER- ❑ 1"METER-
/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 Curre�t Year - Water Meter Pricing Chart *
,%�/" �i' �`�--�
BRAND: i
SIZE: 5/8" ❑ 3/4" ❑ 1" ❑ Other "
�� S/8 x 3/4
III II IIIII I IIII I111 III III II II
SERIAL#: isaoiosz�a R$506712
ERT HIGH#: (if applicab; �I IWII�II I�I� f i I�IIIIIIIIIII��IIIIIIIIIIIII
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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 all statements made on this application are,true and correct.
�����i�� Date: �" � �1�(C __
Applican�
Original: 1-Address File
Make Copies For: 1- Utility Billing Department