HomeMy WebLinkAbout2016-00445 - water meter � • CITY OF ORONO * Z 0 1 6 - 0 PJ 4 4 S *
2750 KELLEY PARKWAY DATE ISSUED: 04/27/2016
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2750 CASCO POINT RD
PIN : 20-117-23-24-0020
LEGAL DESC : CASCO HEIGHTS
: LOT 000 BLOCK 003
PERMIT TYPE : WATER METER-RESIDENTIAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER METER-RESIDENTIAL
NOTE: INSEPCT[ONS ARE DONE BY PUBLIC WORKS DEPARTMENT.
TO SET-UP AN[NSPECTION,PLEASE CALL:(952)249-4613
1"WATER METER
SERIAL NUMBER 53591585
ERT HIGH NUMBER 1541445672
WATER METER RESIDENTIAL HORN 1 WATER METER RESIDENTIAL 1
APPLICANT WATER METER RESIDENTIAL 372.06
WATER METER RESIDENTIAL HORN 144.64
KRG PLUMBING INC TOTAL 516.70
1168 IFFERT AVE SE Payment(s)
BUFFALO,MN 55313- CREDIT CARD 5600 516.70
(612)282-5041
Minnesota State License#:plbg-PC644046
OWNER
Casco Ventures LLC
16192 HIGHWAY 7
MINNETONKA,MN 55345-
AGREEMENT AND SWORN STATEMENT
The work for which this permi[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 rype 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 1 SO 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. !
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Applica ermitee Signature Date Issued By ignature Date
� CITY OF ORONO * Z 0 1 6 - 0 PJ 4 4 5 *
- 2750 KELLEY PARKWAY DATE ISSUED: 04/27/2016
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2750 CASCO POINT RD
PIN : 20-117-23-24-0020
LEGAL DESC : CASCO HEIGHTS
: LOT 000 BLOCK 003
PERMIT TYPE : WATER METER-RESIDENT[AL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER METER-RESIDENTIAL
NOTE: INSEPCTIONS ARE DONE BY PUBLIC WORKS DEPARTMENT.
TO SET-UP AN INSPECTION,PLEASE CALL:(952)249-4613
1"WATER METER
SERIAL NUMBER �^
ERT HIGH NUMBER 1541445672
WATER METER RESIDENTIAL HORN 1 WATER METER RESIDENTIAL 1
APPLICANT WATER METER RESIDENTIAL 372.06
� WATER METER RESIDENTIAL HORN 144.64
KRG PLUMBING INC TOTAL 516J0
1168 IFFERT AVE SE Payment(s)
BUFFALO, MN 55313- CREDIT CARD 5600 516.70
(612)282-5041
Minnesota State License#: plbg-PC644046
OWNER
Casco Ventures LLC
16192 HIGHWAY 7
MINNETONKA,MN 55345-
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 goveming 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 se.
,
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Applicant P mitee Signature - Date Issued B ignature Date
FOR CTl'Y USE ONLY
,�O . `O City of Orono
1V P.O.Box 66 Date Received: Permit#
2750 Kelley Parkway
Crystal Bay,MN 55323 Appraved Sy:(If Required);
(952)249-4600
�F��kE o��'G� CITY OF ORONO-WATER METER FORM
S H (1Vote:Some permrts 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)249-46]6. 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
Che�k All That A 1
[�] Residential(May Require Approval) ❑Commercial(Approval Required)
[`Q New Meter ❑Additional Meter—For: ❑ Replacement Meter
Job Site/Owner Information:
Site Address: �1 ��G C��v� ,��.,�;:.,�-
Owner: �k�� Mailing Address: ��"�� C����-� �-�-- �.��-
City: c7�z�:��� Zip. ����-�, 3
Home Phone: Alternate Phone:
Contractor Informatian:
Contractor: f�1`=�; �� -�`� ^` �1�- Contact Person: ��'^� -�'�'`�"��
Address: f l��� �7��� �a�� �-� State License #: �������������-�
City: �+'a� Zip:����'� Expiration Date: j Z� 3 i-��.-
Phone: (���Z- Z�C��� `�°�'' Alternate Phone:
WATER METER PERMIT FEES
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 *
BRAND: ED2F11 RDG3 'F
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SIZE: ❑ 5/8" ❑ 3/4" (�11" ❑ Other " 53591585
SE�AL#: IIIIIIIIIIIIII'IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII
iu ii ni nn in n u i iiii m ii (if applicable)
ERT HIGH#: 1541445672
ADDITiONAL INFORI�IATION—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.
� �� Date: �-�-1_i �v
Applicant: �� 7,/
Original: 1-Address Fil e
Make Copies For: 1- Utiliry Billing Department
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DATE TIME
�ITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED
PERMIT NO. •�O��O �`��SCOMPLETED
ADDRESS "�� ��
OWNER TELEPHO E �� �/�� �D��1I
CONTRACTOR
� DESCRIPTION (/l�a�h-J " ��
l� ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
O ❑ 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
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
_
J ❑ DEMO-SITE ❑ SEPTIC INSTALL
2 OWNERfCONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� /7��WORK SATISFACTORY:PROCEED �PROJECT COM PLETE
���O CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. G PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP OROER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cail forthe next inspection hours in advance. (952� 249-4600
OwneNContr�ctor on site: ^� -
Inspector. �"��i_✓���'c� 0 � ----
White Copyllnspector's File Cenary CopylSfte Notice �
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CJ ' DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE �u�C� SCHEDULED �i�
PERMIT NO.���h coM ErEo
ADDRESS G �`x�C� �
OWNER TELEPHONE NO. ��� � JD`1I
CONTRACTOR �
� DESCRIPTION � � � L�. l
ty ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINA�(� / Vt- �/
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
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
J ❑ DEMO-SITE ❑ EPTIC INSTALL
2 OWNER/CONTRACTOR TO MEET�pIl��YES_NO
v�, COMMENTS:
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�/�RK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W ❑CORRECT V1fORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL REfURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 2a hours in advance. (g52) 249-46�0
OwnerlContractor on site:
Inspector. ���r�/
White Copyflnspector's File Canary CopylSfte Notice