HomeMy WebLinkAbout2015-01406 - water meter 11111111111111 IN 1111111111111111 Im
CITY OF ORONO * 201S - 01406 *
2750 KELLEY PARKWAY DATE ISSUED: 11/02/2015
ORONO, MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS 2687 WAYZATA BLVD W
PIN 33-118-23-13-0002
LEGAL DESC UNPLATTED 33 118 23
LOT 000 BLOCK 000
PERMIT TYPE WATER METER- IRRIGATION
PROPERTY TYPE COMMERCIAL-BUSINESS
CONSTRUCTION TYPE WATER METER- IRRIGATION
NOTE: THIS IS A 1"METER FOR IRRIGATION,OK'D BY SCOTT O.
WATER METER IRRIGATION HORN 1 WATER METER IRRIGATION 1
APPLICANT WATER METER IRRIGATION 372.06
WATER METER IRRIGATION HORN 121.15
B&D PLUMBING&HEATING INC. TOTAL 493.21
,r4145 MACKENZIE CT NE Payment(s)
ST MICHAEL, MN 55376- CHECK 551557 493.21
(763)497-2290
L
OWNER
Long Lake Properties LLC
8525 E PINNACLE PEAK RD
SCOTTSDALE,AZ 85255-
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.
plicant rmitee SigrwMire nate Issued By Signature Date
City of Orono FOIFt PITY USE ONLY
r� l�
<V P.O.Box 66 Date Received: � U\� Permit#
2750 Kelley Parkway V
Crystal Bay,MN 55323 Approved By:(If Required): Ofv
(952)249-4600
y14, Es o��G CITY OF ORONO—WATER METER FORM
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) 9commerci (Approval Required)
❑ New Meter Additional Meter—For: --r o.A ❑ Replacement Meter
Job Site/Owner Information:
Site Address: � ��� a/
Owner: Ae�—IlclMailing Address:
City: 6) Zip:
Home Phone: Alternate Phone:
Contractor Information:
Contractor: U ! _ Contact Person:
Address: C <P Z State License #:
City: G ,�Zip:.gZ!j� Expiration Date:
Phone: a��v Alternate Phone:
r
❑ 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
BRAND: 526481044
SIZE: ❑ 5/8" ❑3/4" r ❑ Other IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII
SERIAL#:
ERT HIGH#: IIIIIIIIIIIIIIIIIUIIIIIIIIII (if applicable)
1834347794
ADDITIONAL;INFORMATION WATER 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: Date:
Original: ]-Address File
Make Copies For: 1- Utility Billing Department
C m- ,
DATE
G
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED
PERMIT NO. COMPLETED
ADDRESS (-PS 7
OWNER TELEPHONE NO.�IJ�
CONTRACTOR
3: DESCRIPTION
W ❑ FOOTING ❑ DEMO-FINAL;��-�� SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI Owl // ❑ 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
J ❑ DEMO-SITE PTICIN ALL
OWNERICONTRACTOR TO YO YES NO
COMMENTS:
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cc110RKSATISFACTORY:PROCEED PROJECT COMPLETE
cc W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
Q ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contractor on site:
Inspector.
White Copyllnspectoes File Canary Copy/Site Notice