HomeMy WebLinkAbout2017-00320 - water meter CITY OF ORONO III HI! I I I I 1111 :0!
* 2 0 1 7 - 0 0 3 2 0 *
2750 KELLEY PARKWAY DATE ISSUED: 04/04/2017
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2060 WAYZATA BLVD W
PIN : 34-118-23-21-0037
LEGAL DESC : AMBER WOODS OFFICE CENTRE
: LOT 001 BLOCK 001
PERMIT TYPE : WATER METER-COMMERCIAL/INDUSTIRAL
PROPERTY TYPE : COMMERCIAL-BUSINESS
CONSTRUCTION TYPE : WATER METER-COMMERCIAL/INDUSTRIAL
NOTE: INSEPCTIONS ARE DONE BY PUBLIC WORKS DEPARTMENT.
TO SET-UP AN INSPECTION,PLEASE CALL:(952)249-4613
I"WATER METER
SERIAL-52648029
ERT HIGH#1834355276
WATER METER COMMERCIAL HORN 1 WATER METER COMMERCIAL
APPLICANT WATER METER COMMERCIAL 372.06
CBS MN Properties WATER METER COMMERCIAL HORN 144.64
P O BOX 575 TOTAL 516.70
LONG LAKE,MN 55356- Payment(s)
CHECK 22901 516.70
OWNER
CBS MN Properties
P 0 BOX 575
LONG LAKE,MN 55356-
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 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 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.
/ " . V/ 7 / / 7
Applicant Permitee Signature Date Issued By Signature Date
P CITY USE ONLY
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�[j�T City of Orono &O/7- >/�
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Date Ree� ! Per�, #2750 Kelley Parkway1Crystal Bay,MN 55323 Approved By:(IfRequired):
(952)249 4600
o4 ' 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 possible, 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 meter installation.
TYPE OF PERMIT
(Check All That Apply)
❑ Residential(May Require Approval) S Commercial(Approval Required)
(; rlew Meter ❑Additional Meter—For: 0 Replacement Meter
Job Site I Owner Information:
Site Address: 2 C) ,��-) (- ''l-t_-�--'2__,�' -. c v
Owner: C- /-SS" /-M- ` % v'-'�' 74' -,' Mailing Address: 6 a/c c?S--
City: /-._‘.71-,9 / /1_. Zip: �i S
/ Z- -7 D �6t .5 Alternate Phone:
Home Phone: � .c., --- :�--
Contractor Information:
Contractor: (. /J S Contact Person: /�• -sem.__.
Address: //90/70/ S 73 State License #:
City: � Zip:� � ^Expiration Date: 67- 0 Z
Phone: e/-7 -b >� Alternate Phone:
WATER METER PERMIT FEES ,
WILL BE.CAULULATED"BY CITY STAFF
❑ 5/8"METER- D 3/4"METER- 1"1"METER
❑ 5/8"HORN - ❑ 3/4"HORN -
0 "WATER METER (THESE WILL HAVE TO BE SPECIAL ORDERS & -
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 *
BRAND: '1\i-e-D .€_—
SIZE: 0 5/8" ❑ 3/4" (' / - El Other "
SERIAL#: I q L SS a7 cp
ERT HIGH#: 5 aj L 4.E.0, --IG (if applicable)
ADDITIONAL INFORMATION—WATER METERS
The undersigned hereby applies to gr
e City of Orono for issuance of a water meter permit, agrees
to do all work i tric accord. ith the ordinances of the City and the regulations of the State
of Minneso and certi les ' • statements made on this application are,true and correct.
Applicant: ,_ Date: / — 5 — ` p
v,
Original: 1-Address File
Make Copies For: 1- Utility Billing Department
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICEZ,, SCHEDULED — + d
PERMIT NO. ���ZJ..,,7 i� COMPLETED
,,
ADDRESS �- v A 7 f
OWNER TELEPHONE NO.
CONTRACTOR �
31- DESCRIPTION E?! G' £/ C �
LU ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
" ❑ FRAMING 0 MECHANICAL FINAL
ID TREE REMOVAL
• 0 INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
0 RADON SLAB 0 WATER HOOK-UP ❑ PROGRESS
Is 0 FINAL 0 SEWER HOOK-UP 0 COMPLAINT
v ❑ DEMO-SITE 0 SEPTIC MAINT ❑ FOLLOW-UP
0 DEMO-FINAL ❑ SEPTIC INSTALL 0 HARD COVER REMOVAL
❑ PLUMBING RI 0 SEPTIC FINAL ❑ FOUNDATION/REMOVAL
• OWNERICONTRACTOR TO MEET YOU:_11YES_NO
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W ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
CCW
❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
OO ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑PHOTO TAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contractor on site:
Inspector.
White Copyllnspector's File Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICEr p . (; SCHEDULED 7 '1 1-
PERMIT NO. ;3Z011-`1 2 COMPLETED
ADDRESS
OWNER TELEPHONE NO.
CONTRACTOR
•
E DESCRIPTION
W ❑ FOOTING 0 DEMO-FINAL 0 SEPTIC FINAL
Q ❑ POURED WALL 0 PLUMBING RI 0 EXCAV/GRADING/FILLING
112
C ❑ FOUNDATION WATERPROOF 0 PLUMBING FINAL 0 TREE REMOVAL
❑ RADON SLAB 0 MECHANICAL RI 0 SITE INSPECTION
Q 0 FRAMING 0 MECHANICAL FINAL 0 RATED WALLS
❑ INSULATION 0 WOOD BURNER/FIREPLACE 0 COMPLAINT
Q 0 FINAL 0 WATER HOOK-UP 0 FOLLOW-UP
❑ AS BUILT-SURVEY 0 SEWER HOOK-UP 0 FOUNDATION/REMOVAL
❑ DEMO-SITE 0 SEPTIC INSTALL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
to COMMENTS:
cc
W
O
cc
O
W
4c
W
B;
51.1 L)(WORK SATISFACTORY`.PROCEED CI PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED O ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. PHOTO TAKEN
INSPECTOR WILL RETURN
CI
❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call tor the next inspection 24 hours in advance. (952) 249-4600
OwnedContractor on site: 1 /�G4(;—
Inspector. \i
White Copy/inspector's File Canary Copy/Site Notice