HomeMy WebLinkAbout2014-01457 (water meter) �
� + CITY OF ORONO * 2 0 1 4 — 0 1 4 5 7 *
� 2750 KELLEY PARKWAY DATE ISSUED: 12/22/2014
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2690 CAROLINE AVE
PIN : 20-117-23-24-0033
LEGAL DESC : WESSELS SUBD OF SPRING PARK LO
: LOT 000 BLOCK 000
PERMIT TYPE : WATER METER- RESIDENTIAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATEK METER- RESIDENTIAL
NO"TE: INSEYCCIONS ARE DONI;RY PUI3I,IC WORKS DI,PARTMENZ'.
I�O SET-UP AN INSPGC"1'ION,PLEASL;CALL:(952)249-4613
WATER METER RESIDENTIAL HORN 1 WATER METER RESIDENTIAL 1
APPLICANT WATER METER RESIDENTIAL 303.70
WATER METER RESIDENTIAL HORN 86.64
AMERICAN MECHANICAL CO, [NC. TOTAL 390.34
7120 7lST AVE.N. Payment(s)
PO BOX 205 CREDIT CARD 6915 390.34
LORETTO, MN 55357-
(612)750-0278
OWNER
LIBERMAN, 7_IV& T�AL
2690 CAROLINE AVE
WAY'I.A"I�A, MN 55391-
AGREEMENT AND SWORN STATEMENT
I�he work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and die
State Building Codc. This permit is for only the work described and does
not grant permission for additional or related work which requires separatc
permits. All provisions of laws and ordinances goveming[his[ype 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 wit � 180 days t're date of issuance,or if construction is
suspended for p iod of 18 ays at any time attcr work has commenced.
The applicant s r spo i I for assuring all required inspections are
requested in n nn ic �ith the State Building Code."fhis permit may be
revoked at a �t� e r �cause. � -�
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Applicant 'ermit Signature Date [ssued I3y Signaturc Date
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FOR CITY USE ONLY
% City of Orono �,, 7 /
�-��� P.O.Box 66 Date Received: ��� �� ���ermit# �.�-� I�T '���� � `_� ��
2750 Kelley Parkway
Crystal Bay,MN 55323 Approved By:(If Required):
(9�2)249-4600
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CITY OF ORONO–WATER METER FORM
`�KES 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 ineter installation.
TYPE OF PERMIT
(Check All That Apply)
�Residential (May Require Approval) ❑ Commercial(Approval Required)
�] New Meter ❑ Additiona] Meter—For: ❑ Replacement Meter
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Job Site/ Owner Information:
,
Site Address: v � '
Owne���� �v/ �l ���/Yl/eo'I Mailing Address:
City: d Zip:
Home Phone: Alternate Phone:
Contractor Information:
Contractor: / �����(� �'i��i�/�+,�c/���. Contact Person: �w� ���r a�i�C;��
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Address: �(J( ' � C�_ State License #: � `�
City: ��i� Zip.��xpiration Date: /���� (Ci'
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Phone: �/� � �-� Alternate Phone:
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WATER METER PERMIT FEES `
WILL BE CAULULATED BY CITY STAFF
❑ 5/8" METER- �/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: ����,� � ��C_�t i'L.s� � __��c='�s�—�
SIZE: ❑ 5/8" �13/4" ❑ 1" ❑ Other "
sE�aL#: � �- �l —7" ( � � � �
ERT HIGH#: (if applicable)
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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 ' stn t accord c� with the ordinances of the City and the regulations of the State
of Minneso , and rti t all statements made on this application are,true and correct.
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Applicant: Date: /
Original: 1-Address File
Make Copies For: 1- Utility Billing Department 1-Cash Drawer
SC oTfi �
DATE TIME , �
CITY OF ORONO CALLED IN �
INSPECTION NQ I�E SCHEDULED �7 J <<� �
PERMIT NO. � �COMPLEfED
ADDRESS `� �9(� C-� /'Z)/i 11f� ���'
OWNER TELEPHONE NO.���- 7S�'�-�Z/,�
CONTRACTOR '� - ���1- '
>; DESCRIPTION `—`'�� � `���� , ��-����
�
l� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
� ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
y
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
J ❑ PLUMBING RI ❑ SEPTIC FINAL � FOUNDATION/REMOVAL
2 OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS: �
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W ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLEfE
� ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
' O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE CWERING PERMANENT
O CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIREO.CALL TO ARRANGE ACCESS.
Call for the next inspection 2a hours in advance. (J52) 249-460�
OwnerlContractor on site:
inspector.
White Copyllnspector's File Canary CopylSfte Notice