HomeMy WebLinkAbout2015-00230 - water meter � ' � CITY OF ORONO * 2 0 1 5 - 0 0 2 3 0 *
2750 KELLEY PARKWAY DATE ISSUED: 02/25/2015
ORONO, MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS : 709 SANDSTONE CIR
PIN : 33-118-23-11-0044
LEGAL DESC : STONEBAY
: LOT 041 BLOCK 001
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
3/4"NEPTUNE WATER METER
SERIAL NUMBER-52680830
ERT HIGH NUMBER- 18050570703
WATER METER RESIDENTIAL HORN 1 WATER METER RESIDENTIAL 1
APPLICANT WATER METER RESIDENTIAL 294.42
WATER METER RESIDENTIAL HORN 80.42
PRECISION PLUMBING&HEATING INC. TOTAL 374.84
4124 MACKENZIE CT Payment(s)
ST.MICHEAL,MN 55376 CHECK 9782 374.84
(763)497-7486
Minnesota State License#:plbg-PC643806,mech-MB004099
OWNER
Stonebay Builders LLC
14870 BROCKTON LN
DAYTON,MN 55327-
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 dces
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 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.
_ �5 .. � � ��Sl�
.��� � �- ���-
Applicant Permitee Signature Date Issu d By Signature Date
.� • .
FO C USE UNLY
�O� City of Orono /'�
P.O.Box 66 I3a#e Receiv Pemtet#
� 2750 Kelley Pazkway
Crystal Bay,MN 55323 Approvcd Sy:(If R ire�:
(952)249-4600
� �
`� ��,�' CITY OF ORONO—WATER METER FORM
�qkESN� (Note:Some permits may require approval by the Building Official and/or Public Works Department)
GFNERAL TN�URMATIUN
1. WATER METERS must be picked up and paid for at City Hall.
2. If nossible,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.
T'Y'PE C}F;PERMIT
Check Ali That A 1 '
�Residential(May Require Approval) ❑Commercial(Approval Required)
� New Meter ❑Additional Meter—For: ❑Replacement Meter
xc�b Site 1 Owner Infvrmation:
Site Address: � JGl✓1 �)�CS >'►� ���C ��
Owner:��o ��y �U��U-fi'S Mailing Address:
City: (�1��►�1- 0 Zip:
Home Phone: Alternate Phone:
Contractor Information: '
Contractor: ��S��o✓1 Q��^���►1(, .�hL Contact Person: ("tl ��--G_
Address: � l �� M�^�C�n�,L State License #:
Lo..1/f yl�
City: �� M,�hr,�l Zip:� Expiration Date:
Phone: �� l ��� 7"����' Alternate Phone:
. � �
, ;, �
��
� ��., �, �,�,.. ��
��.
❑ 5/8"METER- `METER- ❑ 1"METER-
❑ 5/8"HORN - 3/ `HORN - ❑ 1"HORN -
❑ "WATER METER (THESE WILL HAVE TO BE SPECIAL ORDERED&PRICES DETERMINED)
1. METER FEE: $ � / � ` �
2. HORN FEE $ o Q• �`-
3. TOTAL PERMIT FEE(Add Lines 1-2 Above) $ �
CITY-USE ONLY
* For Current Pricing Re er to Current Year- Water Meter Pricing Chart *
BRAND: � ( �/l.� 1 �
SIZE: ❑ 5/8" �/4" ❑ 1" ❑Other "
� �,
SERIAL#: � ZCp DD���
ERT HIGH#: III III1111I IIIII I IIII I I I IIIII (if applicable)
1850570703
A.DDI'TI(7I�1AL IN�()RMATIC?1`�T:-Wt�TER 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.
Applicant:� " ^�f Date: �"�S ^ ��
.
Original: 1-Address File
Make Copies For: 1- Utility Billing Department
_ ___ _ .._ ..___.. ___ _
��_._._._...._.r. _�_—__ .__ . ___— /�DDf�ESS �B(tLING N(J(�IE i't-IU�v�
S E RV I C E �..._._. ..v.� �._
._ �..__. ______�..�..._ �.._ —--�
_.� _____. _____ r
�..�__---__-- __ ____ aOW N E R 4-�4 M� P H O N E �
.� '"�¢.��.�`�'in����_�.'____�_ _.._._ _`"��_�..��__.���
; � '? ___ _ �� _ __. �
_��— ' �IL�.ING WC+RK PHt?N� "
p ! ____�_.__.____w�.__��.�..�._.�.-- ,
C7��1� � .. . , .. � ._....._..a._....V.__.�_�__..�. � �
_ .�_.,___.�.�--- R W fJ R�C P H O N� ��
01NN -- � � C7WN� .�..W.�..�_�___.--__ ----�
__.___�._..__ BOI�K�'STC7 P: '
_w._.�___AC C O U NT N U M B E R�_._...�._._ ._.. w_._._ _._._..�� r._.. .�____�..._.,.
�
� _�_� __._._ -- ---
..___ _.________�_,__�_�__ ______. _�_______._.____ C A L.L T'A K E N �Y:
__...,_._�.__DATE/TI�liE fF CALLED IN: � .._�___�_.. .�.�._.___.�.��_.�.--.—:��—�-�---�__
_ ___ __.�_ .____,__._____ � _.,_ ..�.__. ___
�� _ . —---------�--�--- �---�—�-�
NA`CURE OF WORK ORDER ,� .
i�' �r`"�� `�' �r'��f Jt'�`" �,
� � � � .,_ _..._ _._
� _� _ Si�E _ N1AKEi SERIAL �fUM�ER �LAST RFA1�ii�G DA�
GURRENT METER ~
; .__._..._ ----- - �--- -- - -..._ _ _�____w,
Date instalfed ERT NUMBER LAST tV�E3'EF�. ft�A��
� __.___.____._.._ ____,�_.
, _� __. __ ____ .___.
� � ` _ .__--__ __.w_ -^_ __ _
S�RlAt.. NUMBER i� 1NSIDE REA►Dl�iC:
- METER REMOV�D � �_ _�_.___�...__ -
_.—�------ ______ ____..---
ERT NUMBER OUTS�DE ���,T.)##�
{ _..�. _.�.. _:.r�____
� � � �
,_ _--
, __ _._._...._-------
__. _..r_.�._.�... --�-�_�_
f___ ----__ _ _- - ;MC`�D�L.: D�SC SERiAL. Nt�11ifBER __�° �tEV1l �Td�RT�NG ��
�_________� � � _.�.____�_. _
��f�TER IN�TA�.LED , FL or SP � �
; �..�.__.___
� � �RT NUMB�R
< ; { .__� __._.�___.�___
�
< i.___-_-_�.__..._._._._..__. �....__�_.�_��
_____._._ �_._____ � _�,
,-. _ .�.. � �_______...�.�_..,_ _.___ - ____. �.
_ ��. w_. . �____ _._.__�_ _.
; t-�CJ1N �C7RREGTED�
�-- - __.._..►
_______._._______ .____. ..
; ,._ _ __________ .__ _____.__.�_�________.�__�_.�..
� ��°' .�-- � �`` /���� 3�'�' � �,` ___.____ .�__
�� �
. ....� .� _�- -_ �-,� � � ��� �� �� ,
� _ � �
� _ �� ��� � � ����.��, ;����
�
�
_ ___.�_�-��_�. .�.__._�_
_ _ ___ __ � _ _ _ _._
_ ___.��.��_ __
: �.�- ___..__.__. _____�_ .._ . ._._
� ff����� . _ _ __ _ _
�� _ .
,
: .�._ ._�� ._�s
_ _____ _ __
, o __ _ _ _ _
� � x .,� a . �.
� " � � ,� � �� `'� �
z `� :,�� � �`t� �� � , ,..
�� � 1` �`�� � � � y '�t � � — _ �� :
_,�, ,4 S . � Vr 4,� ����... �, � �.-+� � � �+� �f� .
'b �aS 1�'S 1fy '��t.�`'.�`�� ' �.• � . . . . �+-....a�_ ,.......�.-....."w_.'.�'^�.^•�r...._..+._.+r.-....��.._,. _.....-_,.....__
t� �.5'-.��i fi i. � . . � � .
r r � --,..____._._..._
� ����� �� -...,.._ . �__ � �.��1���4d. �__.__.._. ,._._____
°+ b Y ,�h �___..,....._ "M""'"---.�.� — _;�,_ —______ -
. �.r�
��`��� �,� .��'�(�INTNf��T: �}C�P►i � �
. � , _ � E � 7 / �f�,�,
�,: y� r�}el-..vf J�,.y�fi,A •�: • � . .� +rvd-..,.....r.w,... _ . . . '_'.._ _ {. .__--_-_.. .'�"�ic-se.--._.c�.s_-ws+ycrv�.
-�w-.r.�....�_�+�+�...v....-..-e....�_ _.! ..�.. . . �� { ����r/ �
.. . ..v.H Y .�. . .. .� . � �. � ..-.... �......... ....