HomeMy WebLinkAbout2015-00231 - water meter CITY OF ORONO * Z 0 1 5 - 0 0 2 3 1 *
2750 KELLEY PARKWAY DATE ISSUED: 02/25/2015
ORONO, MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS : 711 SANDSTONE CIR
PIN : 33-118-23-I1-0045
LEGAL DESC : STONEBAY
: LOT 042 BLOCK 001
PERMTT 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
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 CREDIT CARD 9782 374.84
(763)497-7486
Minnesota State License#:plbg-PC643806,mech-MB004099
OWNER
Stonebay Builders LLC
14870 BROCKTON LA
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 Iaws 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. ���/
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Applicanf'Permitee Signature Date Issued By �gnature Date
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FOR C USE UNLY
� , City of Orono � Z � �
�0� P.O.Box 66 Date Received: I�?enmit# ,�,,, '�' �
� 2750 Kelley Parkway �
Crystal Bay,MN 55323 Approved$y:'{If Rcquirod}; �'�-��,,,;,,�,,,�,
(952)249-4600
�`�� �,�� CITY OF ORONO—WATER METER FORM
�'�ES H O�
(Note:Some permiu 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 osn sible,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�FE OF PERMIT ::
' Check All That A 1
�'Residential(May Require Approval) ❑ Commercial(Approval Required)
[�'New Meter ❑Additional Meter—For: ❑Replacement Meter
Job Site/Owner�nfozmation:
Site Address: �—T�>c�v1�, � ��✓1� <<�C ��
Owner:.S � �►'1� �u`� !J'^� '��C�'S Mailing Address:
City: d rD�I) Zip:
Home Phone: Alternate Phone:
Contractor Infarmati�n:
Contractor: ����� �d✓1 I lU►�►��� lcx Contact Person: /� � �
Address: ��� Z � �'1�C��t�17_, � State License#:
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City: J Zip:�� 1-�� Expiration Date:
Phone: Tb3 — ����- -�y�� Alternate Phone:
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❑ 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) $ b'��7 z `�
CITY-USE ONLY
* For Current Pricing Refer to Current Year- Water Meter Pricing Chart *
B�,ND: ....e�J�-u�--
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SIZE: ❑ 5/8" �]3/4" ❑ 1" ❑Other "
SERIAL#: � � � �� �V
ERT HIGH#: _ NI III III III I III II I llll II IIII (if applicable)
1832388305
AI�Ll�TICttt�'��N'F171�MATI4N—WATER IU�ETERS
The undersigned hereby applies to the City of Orono for issuance of a water meter permit, agees
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��.2r� `�� Date: 2��-S r- �>
Original: 1-Address File
Make Copies For: 1- Utility Billing Department
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