HomeMy WebLinkAbout2009-00092 - water meter �
� CITY OF ORONO PERMIT NO.: 2009-00092
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE IssuED: 03/06/2009
952 249-4600 FAX: 952 249-4616
ADDRESS : 3546 IVY PL
PIN : 20-117-23-42-0018
LEGAL DESC : TAYLORS SUBD OF SPRING PARK LO
: LOT 000 BLOCK 000
PERMIT TYPE : WATER METER
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER METER
NOTE: INSEPCTIONS ARE DONE BY PUBLIC WORKS DEPARTMENT.
TO SET-UP AN INSPECTION,PLEASE CALL:(952)249-4613
WATER METER RESIDENTIAL HORN 1 WATER METER RESIDENTIAL 1
APPLICANT WATER METER RESIDENTIAL 394.67
STEWART PLUMBING, INC. WATER METER RESIDENTIAL HORN 104.45
13025 GEORGE WEBER DR
SUITE#1 MISC FEE 0.00
ROGERS,MN 55374 TOTAL 499.12
(763)428-1833
OWNER
DRAZAN, MICHAEL&MARY
3546 NY PL
WAYZATA, MN 55391-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performcd 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 a�time for due cause.
1� /``�` ~� � l � l Q l � ���LGli3'�- l l
�licant Permitee Signature Date Issued By nature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED BOVE.
t.
s�
FOR CITY USF ONLY
,��� City of Orono
� � P.O.Box 66 Date Reccived: Permit#
�,.H.. 2750 Kelley Parkway
a �1�'�;�_�'. � Crystal Bay,MN 55323 Approved[3y:(If Required):
��" '����� v,o` (952)249-4600
� �3=' $
88H�8
CITY OF ORONO—WATER METER FORM
(*Notc: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�ossible, 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)
�
Q New Meter ❑ Additional Meter—For: ❑ Replacement Meter
Job Site/ Owner Information:
3 (P
Site Address: _� .l� /v Y {�/�4�� �.rc:, •'�a
Owner: Mailing Address:
City: Zip:
Home Phone: Alternate Phone:
Contractor Information:
Contractor: -�'��'-'��� ����'"`�-^' Contact Person: ��� �
�
Address: �-300�SJ �e���t ��`-'� State License #:
City: ��q �''� Zip: Expiration Date:
Phone: ���"" yo2�- ���� 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 1-2 Above) $
CITY-USE ONLY
* For Current Pricing Refer to Current Year- Water Meter Pricing Chart *
B�,rrD: V�EC��wn.Q_ �
sizE: ❑ sig°° ❑ 3i4�� [�,i°, ❑ otner „
S ERIAL#: ����������������������������� S�3�D$f 3
1820458154 �
ERT HIGH#: (if applicable)
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: � 6 G•
Original: 1-Address File
Make Copies For: 1- Utility Billing Department 1- Cash Drawer
D /� TIME V
CITY OF ORONO CALLED IN �-�D-I
INSPECTION NOTIC SCHEDULED
PERMIT NO. —���OMPLETED � -T�n -d�
ADDRESS ���� �G��
OWNER CONTR. s ��
TELEPHONE NO.�` �`Z �Z z�l� �Q'�BN�
� DESCRIPTION �1����'.��[ ''�LG2� �J��'�
� ❑ FOOTING ❑ MECHANICAL I ❑ EXCAV/GRADING/FILLING
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS
y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE
❑ TREE REMOVAL
Z ❑ WALL BD. p WATER HOOK-UP ❑ SITE INSPECTION
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
� ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
_ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
J ❑ PLUMBING FINAL p FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
y COMMENTS:
�
W
C
�
�
O
�
�
O
�
W
�
Q
�
Z
W
�
W
� .
�
��RK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFOREC�IERING PERMANENT
0 CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WFLL RETURN
❑STOP ORDER POSTED.GALL INSPECTOR ❑CITATION ISSUED
❑ IPiSPECTIONRE0UIRED.CALLTOARRANGEACCESS.
Cail for the next inspection 24 hours in advance. (g52) 249-4600
Owner/Contra �,��
Inspecto . k
White Copyllnspecto�'s File Canary Copy/Site Notice