HomeMy WebLinkAbout2016-00008 - water meter � ,� CITY OF ORONO * 2 P1 1 6 — 0 0 0 0 8 *
2750 KELLEY PARKWAY DATE ISSUED: OU05/2016
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2560 KELLY AVE
PIN : 20-117-23-11-0007
LEGAL DESC : REG. LAND SURVEY NO.0088
: LOT 000 BLOCK 000
PERMIT TYPE : WATER METER-RESIDENTIAL
PROPERTY TYPE : COMMERCIAL-BUSINESS
CONSTRUCTION TYPE : WATER METER-RESIDENTIAL
NOTE: INSEPCTIONS ARE DONE BY PUBLIC WORKS DEPARTMENT.
TO SET-UP AN INSPECTION,PLEASE CALL:(952)249-4613
3/4" WATER METER AND HORNS
SERIAL NUMBER 1540370834
ERT HIGH#53456584
WATER METER RESIDENTIAL HORN 1 WATER METER RESIDENTIAL 1
APPLICANT WATER METER RESIDENTIAL 294.42
WATER METER RESIDENTIAL HORN 80.42
EASCO PLUMBING&HEAT[NG INC.
7965 PLONEER TR TOTAL 374.84
LORETTO,MN 55357 Payment(s)
(612)369-5486 CREDIT CARD 3448 374.84
OWNER
International Ministerial Fellowshi
P.O. BOX 100
NAVARRE, MN 55392-
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 l80 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�time for duecause.
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�t ant Permitee Signature ate Issue B� ' nature Date
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FOR CITY U$E ONLY
�O�TO City of Orono
1 y P.O.Box 66 Date Received: Permit#
2750 Kelley Parkway
Crystal Bay,MN 55323 Approved By:(If Required):
(952)249-4600
�`��.�kFs oR�,�'� CITY OF ORONO—WATER METER FORM
H (Note:Some permits may reqwre approval by the Buildmg 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]et 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
(Check All That A 1 )
Q Residential(May Require Approval) ❑Commercial(Approval Required)
� New Meter ❑ Additional Meter—For: ❑ Replacement Meter
Job Site/Owner Information:
Site Address: �S�C � t�.-e l I�,� t`�1 v �
Owner: Mailing Address:
City: Zip:
Home Phone: Alternate Phone:
Contractor Information:
Contractor: ��t S � `' ����� Contact Person: �'��� �
Address: � Cl� S � � �'�`��� � �` State License #: U �� �'� v
City: � � �"c�`-' Zip:SS35`7 Expiration Date: ��f 3� �7
�
Phone: 1 � �Z��(�1 S��C.� Alternate Phone:
.
WATER METER PERMIT FEES
�1+TILL 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�ND: 3/4
53456584
SIZE: ❑ 5/8" ❑ 3/4" ❑ 1" ❑ Other , IIIIIIIIIIIIIIIIIIIIIIIIIIIIII�IIII I III II
sE�ai,#: .5 3� S�5��
iuuuiinmiinwuuiiu if a hcable
ERT HIGH#: 1540370834 �� 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.
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Applicant: _�--�—� Date: _1/ ` ��
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Original: 1-Address File
Make Copies For: 1- Utility Billing Department
/
DATE TIME �
CITY OF ORONO CALLED IN
INSPECTIO ,OTICE� � scHE�u�E� � �I�:C��
�ERMIT NO. �- COM�LETED
ADDRESS �- �JTD G ��`�-tC��.�-�L
OWNER TELEPHONE NO.��� 3�� -��
CONTRACTOR � ���-
� DESCRIPTION c��'���' �'`t�'Y �f�� I l �'�'�� W�r
ty ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL U�
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
4J ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
_
J ❑ DEMO-SITE ❑ SEPTIC INSTALL
2 OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:�'���d G���� /9�" �i'-�-�
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���,�ORK SATISFACTORY:PROCEED PROJ ECT COM PLEf E
� ❑CORRECT WORK 8 PROCEED �SSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REtNSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTOTAKEN
INSPECTOR WFLL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cail forthe next inspection 24 hours in advance. (952) 249-4600
OwnerfConVactor on site:
Inspector. "�/'-��
White CopY��nspector's Ffle Canary CopylSfte Notice