HomeMy WebLinkAbout2016-00579 - water meter , . CITY OF ORONO * 2 0 1 6 - 0 0 5 7 9 *
2750 KELLEY PARKWAY DATE ISSUED: OS/24/2016
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 3596 SHORELINE DR
PIN : 17-117-23-43-0107
LEGAL DESC : NAVARRE HEIGHTS
: LOT 000 BLOCK 007
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 INSPECT[ON,PLEASE CALL:(952)249-4613
1"WATER METER-ERT HIGH# 1852991048
SERIAL#53354891
WATER METER RESIDENTIAL HORN 1 WATER METER R�SIDENTIAL 1
APPLICANT WATER METER RESIDENTIAL 372.06
WATER METER RESIDENTIAL HORN 144.64
EXCEL MECHANICAL, INC. TOTAL 516J0
11582 COUNTY RD 13 Payment(s)
WATERTOWN, MN 55388 CREDIT CARD 0810 516.70
(952)393-2403
OWNER
The Woffington
3596 SHORELINE DR
WAYZATA,MN 55391-
AGREEMENT AIVD 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 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.
"�y-�� � -�� � iZ�/ ��
Appli nt ermitee Signature Date Issued By S' ature Date
. , .
FUR CiTY USE O1V�.Y
�O A rO City of Orono
f y P.O.Box 66 Ilate Received: Pet�nit#
2750 Kelley Parkway
Crystal Bay,MN 55323 Approved By:(ff Rcquired);
(952)249-4600
���-9,�E o���'Z CITY OF ORONO—WATER METER FORM
S H (Note: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 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.
TYPE O�PERMIT
Check All That A l
❑ Residential(May Require Approval) ❑ Commercial(Approval Required)
❑ New Meter ❑Additional Meter—For: �Replacement Meter
Job Site/Owner Information:
Site Address: 3`�cj� ���i,� rQ/
Owner: Mailing Address:
City: Zip:
Home Phone: Alternate Phone:
Coniracto�Informatian:
�
Contractor: ���� rU���., �_r _►=<�c Contact Person: ���y
Address: t��-z C'Y. �3 c � State License #: �.3'�r�� !��
City: t,•-�--r���� Zip�.�" Expiration Date: l,'1-��/ " ��
Phone: �%S`,L -3���� �`t'u-� Alternate Phone:
r . y
WATER METER PERMIT �EES
WILL BE CAULULATED BY CITY STAFF
❑ 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 i-2 Above) $
CITY-USE ONLY
* For Current Pricing Refer to Current Year- Water Meter Pricing Chart *
,
53354891
B�ND: IIII I II II I I IIIII I I I I II II
SIZE: ❑ 5/8" ❑3/4" 1" ❑ Other "
SERIAL#:
ERT HIGH#:
(if applicable) III IIII1I$I52I99I'II��I$III III
ADDITIONAL iNFOitMATION—WATER METERS
The undersigned hereby applies to the City of Orono far 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: � ����Y
Original: 1-Address File
Make Copies For: 1- Utility Billing Department
�� ��� A E TIME
CITY OF ORONO CALLED IN ��� �
INSPECTION NQTICE SCHEDULED _�1
PERMIT NO. GD — 9 COMPLEfED
�p�s0°� �S`'1 lo �(rw re ��►v� �►Z
OWNER TELEPHONE NO.
CONTRACTOR �X cD � I�Y�Q6C.Q...
� DESCRIPTION 6�P�- � �a-1 �a�^
ly ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FIN
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
? ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
v ❑ DEMO-SITE ❑ SEPTIC INSTALL
2 OWNERfCONTRACTOR TO MEET YOU:_YES_NO �
° COMMENTS: �t^�f F�� 5 r n 1� �
Wp�.�.�.n
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W ❑WORKSATISFACTORY:PROCEED ❑ PROJECT COMPLEfE
� ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CAII FOR REINSPECTION TEMPORARY
V BEFORE CWERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cail for the next inspection 24 hours in advance. (952� 249-4600
OwnerlCon tor on site:
Inspector. `
White Copyllnspector's File Canary CopyfSite Notice