HomeMy WebLinkAbout2014-00828 (water meter) . ' CITY OF ORONO * z 0 1 4 — 0 B S 2 8 *
2750 KELLEY PARKWAY pATE �SSUE�: 08/04/2014
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2625 CASCADE LA
PIN : 33-118-23-11-0116
LEGAL DESC : STONEBAY FIFTH ADDITION
: LOT 006 BLOCK 001
PERMIT TYPE : WATER ME'�ER- RESIDENTIAL
PROPERTY TYPE : RFSIDENTIAL
CONSTRUCTION TYPE : WATER MGTER - RESIDENTIAL
NOTE: INSEPCT[ONS ARr DONE f3Y PU[3LIC WORKS DEPARTMENT.
TO SF,T-UP AN INSPECTION, PLLASI?CALL:(952)249-4613
NF,PTUNE 3/4" WA'I�L:[Z M[;"1'GR
SERIAI.NUMBER-�2191607
ER"I'1{[GFI NUME31?R 183152677�
WATER METFR RESIDENTIAL HORN 1 WA'TER METER RES[DENTIAL 1
APPLICANT WATER METER RESIDENTIAL 303.70
WATER METER RESIDENTIAL HORN 86.64
PRECISION PLUMBING & HEATFIING INC.
4124 MACKENZIE CT TOTAL 390.34
ST. MICHEAL, MN 55376 Payment(s)
(763)497-7486 CREDIT CARD 9824 390.34
Minnesota State License#: plbg-PC643806,mech-MB004099
OWNER
BUILDERS LLC, STONEBAY
16135 SSTH AVENUE NORTH
PLYMOUTFI, MN 55446-
AGRF,F.MENT AND SWORN STATEMF.NT
�fhc�+�ork lor which this permit is issued shall be performed according to
dic approved plans and specifications,applicablc City approvals,and thc
State E3uilding Code. This permit is for only the work described and docs
not grant permission for additional or related work which requires separa[c
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified herein.'I�his permit will
expire and become null and void if construction authorired is not
commenced N�•ithin 180 days ofthe date of issuance,or if construction is
suspended for a period of 180 days at any time at�ter work has commenced.
�he applicant is responsible fo suri g all required inspections are
requested in conformance w� the Sta k3uilding Code.'I�his permit may be
revoked at y time for�u cause.
.
�� ����� �� �i 4� i /
Appl� ant Permitee Signature Date Issu I3��Signature Date
�
O C Y USE ONLY
Cit of Orono � � '^� Q
�-O� P.O Box 66 Date Receiv�c�, � Permit�C/ U
� 2750 Kelley Parkway
Crystal Bay.MN 55323 Approved By:(IfRequired):
(9�2)249-4600
�, �
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�KESH���G CITY OF ORONO—WATER METER FORM
(*Note:Some permits may require approval by the B�ilding Official and/or Public Works Department
«�
GENERAL INFORMATION
1. WATER METERS must be picked up and paid far 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 Appl )
❑ Residential (May Require Approval) ❑ Commercial (Approval Required)
�New Meter ❑ Additional Meter—For: ❑ Replacement Meter
Job Site / Owner Information:
Site Address: a 6 pl 5 �NS ��� ��
Owner: S��nL b�.y �Id'� MailingAddress:
City: ����r�a Zip:
Home Phone: Alternate Phone:
Contractar Information:
,�y� � �
Contractor: I����.�Sro., r j�5�,��/�r��h5 i,�;Contact Person: / �� �l� `� � lD<<-1�'�S�r
Address: Y�a y �ckc�,'� �1�. �� State License #: P/��6 aZ 3� �
City: 5�. ����4c1 Zip:Sr"31fi ExpirationDate: �oZ - 3�� � y
Phone: ��,�j ' ���� ' ��/�( Alternate Phone: ��,� ` �3 �� ���6
�
WATER METER PERMIT FE�S
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 1-2 Above) $
CITY-USE ONLY
* For Current Pricing Refer to Current Year- Water Meter Pricing Chart *
BRAND:
SIZE: ❑ 5/8" [�3/4" ❑ 1" ❑ Other "
SERIAL#: � � � �' / Lv � 7
ERT HIGH#: II�III���III�I III II�I I I(I��II �f a licable
— 1831526775 � PP )
ADDITIONAL 1NFORMATION—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: �� 1'T >Y
Original: I-Address File
Make Copies For: 1- Utiliry Billing Department 1-Cash Drawer