HomeMy WebLinkAbout2018-00379 - water meter � � . CITY OF ORONO * Z � 1 8 - 0 P1 3 7 9 *
2750 KELLEY PARKWAY DATE ISSUED: 03/29/2018
ORONO,MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS : 1720 SHADYWOOD RD
PIN : 17-117-23-21-0019
LEGAL DESC : SHADY WOOD
: LOT 000 BLOCK 000
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)249-4600
1"NEPTUNE METER
SERIAL 53713916
ERT# 1542825350
WATER METER RESIDENTIAL HORN 1 WATER METER RESIDENTIAL 1
APPLICANT WATER METER RESIDENTIAL 388.15
WATER METER RESIDENTIAL HORN 144.64
SERVIN PLUMBING&HEATING
24752 705TH AVE TOTAL 532.79
DASSEL,MN 55325 Payment(s)
(320)275-0190 CREDIT CARD 4098 532.79
OWNER
HANSBERGER,TRAVIS
651 LEXIE CT
EAGAN,MN 55123-
AGREEMENT AND SWORN STATEME1vT
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 governing this type of work
shall be compied with whether or not specified herein.This permit will
expire and become nuli 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.
T a licant is responsible for assuring all required inspections aze
re be`ed i conformance with the State Building Code.This permit may be
r 4k� at me fo e cause.
, �
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A p cant e itee Signature Da Issue y Signature Date
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City of Orono
�� P.O.Box 66 Dat¢lt�aVai:� g��t�� �
� 2750 Kelley Parkway
Crystal Bay>I�IId 55323 A�sa�d Hy;(�'
(952)249-4600
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qkESH04�" CITY OF ORONO—WATER METER FORM
(Note:Some pecmits may require approval by the Building Official and/or Public Wotks Depar�t)
� '�E�.,�F���►��
1. WATER METERS must be picked up and paid for at City Hall.
2. I�ssible,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 sesled by Orono Water Department (952) 249-4600,
upon completion of ineter installation.
`3''Y£�C�F P�I�iA�TT :
�Al�'T�
❑Residential(May Require Approval) ❑Commercial(Approval Required)
�A1ew Meter ❑Additional Meter—For: ❑Replacement Meter
Job S�e/ �:
Site Address: _1�1 Z o �J�ac�� t,► br�C� �C�
Owner: L C Q�.w�E� /�Na.�Sl�e rqe� Mailing Address:
City: Zip:
Home Phone: Alternate Phone:
Cca �on:
Contractor: �Y��� t��Wl��'r� Contact Person: �i w1 ����`,it.
Address: 71 a�S o��6� �5-� State License#: (�w1 p(o,�ol�{tp
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City: ��'� Zip:553�5—Expiration Date: �
Phone: 3�-Q���f6610 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) $
CITY-USE ONLY
* For Current Pricing Refer to Current Year-Water Meter Pricing Chart * �
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B��� 53713916
SIZE: ❑5/8" ❑3/4" �1" ❑Other '� IIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIIII�IIIIIIIII
SERIAL#:
��4282 35�
ERT HIGH#: (if applicable) �5
AD�i'T��i1�I..Il�iFO�IA'T'ION—�ATER A�[LTERS
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 applicatiori are,true and correct.
Applicant: �� Date: 3 O�
, � .�.'.
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Original: 1-Address File
Make Copies For: 1- Utility Billing Department
c -� .s�-
� DATE TIME
CITY OF ORONO cnLLED IN
INSPECTION TICE SCHEDULED - 8-!8
PERMIT NO. �y COMPLETED � _��
ADDRESS � �� -�%�'.�G1Gt.�'J4Qi �d `
OWNER TELE ONE NO. ��0���"�3�{
CONTRACTOR � � � � LS
� DESCRIPTION �L����-�- !1 _�
4~j ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
� ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
O ❑ FOUNDATION DRAIN TILE ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ LATHE ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
_
v ❑ DEMO-SITE ❑ SEPTIC INSTALL
2 OWNERICONTMCTOR TO MEEf YOU:_YES_f�
� COMMENTS: •F'te v/4G� �
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� �WORK SATISFACTOR�F.PROCEED ❑PROJECT COMPLEfE
w ❑CORRECT IMORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECONERING PERMANENT
❑CORRECT UNSAFE CONDITION WRHIN HOURS. p pHpTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cail for the next inspectbn 24 hours in advance. (952) 249-4600
OMrnerlContractor on site:
Inspeator: ��� �
YVhite Copylln�ectors File Canary CopylSiN Noties