The URL can be used to link to this page

Home My WebLink About2017-00479 - water meter CITYOFORONO * 2017 - 0PJ479 * • 2750 KELLEY PARKWAY DATE ISSUED: OS/1 U2017 � ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 2649 CASCO POINT RD PIN : 20-117-23-24-0029 LEGAL DESC : SPRING PARK : LOT 138 BLOCK 000 PERMIT TYPE : WATER METER-RESIDENTIAL PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WATER METER-RESIDENTIAL NOTE: [NSEPCTIONS 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 372.06 WATER METER RES[DENTIAL HORN 144.64 D[VERSIFIED PLUMBING&HEATING P O BOX 91 TOTAL 516J0 CHASKA, MN 55318- Payment(s) (952)448-0756 CHECK 5201 516.70 Minnesota State License#: plbg-71354924 O W IYER KINDL, DUSTIN&CASIE 4898 BARTLETT BLVD MOLIND, MN 55364- 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 afrer 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 fqr due cause. `j� n, / lA ) � ,� � ►I � 1Z�� /��_-( �,� i==�� il � t A ic t Permite ignatu D te Issued By Signature Date FUIt CITY USE OIVI.Y City of Orono � �-�� P.O.Box 66 IIate Iteeeived: �- �(� Pertnit# ��'�� - �'G�{�� 2750 Kelley Parkway Crystal Bay,MN 55323 Apgrrn$d By:(Ifitcquited): (952)249-4600 ��.�,�E aR�.�'Z CITY OF ORONO—WATER METER FORM S H (]�*ate:Some perm�u 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 lrnow 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 PERI�T'T Check All T'hat A 1 �Residential(May Require Approval) ❑ Commercial(Approval Required) �] New Meter ❑Additional Meter—For: ❑ Replacement Meter � Jab Site/Owner Information: Site Address: �! 02� �I�1 ��c-' �� Z�� Owner: �t�"� ��-'"2 S Mailing Address: ��I � �n�� c,v e `j City: �'-��`��`-� Zip: `�S 3�d Home Phone: `�5� - �`� � -�3�� Alternate Phone: Con#ractor Informati4n: Contractor: I��'``�s�,��c\ ��w��,�J Contact Person: L°� I��✓� �C; ,�� Address: �`� �"'� `� � State License #: �C �� City: C�'y`5 � " Zip:S 5 3�� Expiration Date: � � I �� Phone: �� y�'' `�� 5� Alternate Phone: WATER METER PE�MIT�EES ' WII,L BE CAULULATED BY CITY STAFF �"METER- ❑ 5/8"METER- ❑ 3/4"METER- n �HORN - ❑ 5/8"HORN - ❑ 3/4"HORN - `7O � "WATER METER (THESE WILL HAVE TO BE SPECIAL ORDERED&PRICES DETERMINED) .� C,�;� 1. METER FEE: $ � � 2. HORN FEE $ I �� 3. TOTAL PERMIT FEE(Add Lines 1-2 Above) $ � � �� CITY-USE ONLY * For Current Pricing Refer to Current Year - Water Meter Pricing ED2F11 RDG3 � ,.. BR�.ND: 5359IIII�IIIIIII�IIIIIIIIIIIII SIZE: ❑ 5/8" ❑ 3/4" 1" ❑ Other " � IIIIIIIIIIIIIIIIIIIIIIII SERIAL#: �y / l�� iiunii uu i u iii m ini u ii � 1541556814 ERT HIGH#: (if applicable� ADDITIONAL INFORMATION—WATER METEI�S 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 al] statements made on this application are, true and conect. /� r, .� Applicant: IL u�^ l,'I<�h r✓��'�'� Date: `� �� Original: 1-Address File Make Copies For: 1- Utiliry Billing Department � C_ I D DATE TIME� CITY OF ORONO CALLED IN INSPECTIONNOTICE SCHEDULED (0�2' 1�1 �O PERMIT NO. 2��1'��9 COMPLETED ADDRESS 5�.1� -1 SL Pn '�'� • t'. OWNER TELEPHONE NO.�Z��TZ CONTRACTOR �� DESCRIPTION � ❑ FOOTING �PLUMBING NAL ❑ EXCAV/GRADING/FILLJNG Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHOHE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL 2 ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL O SEWER HOOK-UP ❑ COMPLAINT v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI 0 SEPTIC FINAL ❑ FOUNDATION/REMOVAL Z OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS'.�/- ►�,�'�• �rt��i.+�et ��i_ �:, .,.aa,�'�is,r l� �.�arrivr � �. j . �� ^ f.ti� a/ O � -�'/�v� ° � l�N � W " � � �dN ' z� Q � ,i� ��G ,� '�1 a �a c�� T.-,z� o�GZs,6 ,� � � 2 W � W �[ � � W ❑WORK SATISFACTORY:PROCEED ❑PROJECT COMPLEfE � ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECONERING PERMANENT �ORRECTUNSAFECONDITIONWITHIN HOURS. ❑pHOTOTAKEN � � INSPECTOR WILL REfURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (g52) 249-46�� OwnerfContractor on site: Inspector. ��+�'�G White CopYllnspector's Ffle Canary CopylSMe Notice