HomeMy WebLinkAbout2016-01053 - water meter � CITY OF ORONO * 2 0 1 6 - 0 1 0 5 3 *
� 2750 KELLEY PARKWAY �
DATE ISSUED: 08/30/2016
ORONO,MN 55356-
(952)249-4600 FAX: (952 249-4616
ADDRESS : 3438 LYRIC AVE
PIN : 17-117-23-43-0077
LEGAL DESC : NAVARRE HEIGHTS
: LOT 023 BLOCK 005
PERMIT TYPE : WATER METER-RESIDENTIAL
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
3/4"METER
SERIAL#53314734
ERT HIGH# 1852887660
WATER METER RESIDENTIAL HORN 1 WATER METER RESIDENTIAL 1
APPLICANT WATER METER RESIDENTIAL 294.42
WATER METER RESIDENTIAL HORN 97.57
AIR MECHANICAL,INC. TOTAL 391.99
16411 ABERDEEN ST NE Payment(s)
HAM LAKE,MN 55304 CREDIT CARD 6736 391.99
(763)4347747
Minnesota State License#:mech-MB005122
OWNER
Landsource LLC
KOHOUT,JAMISON
550 25TH AVE N
ST CLOUD,MN 56303-
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 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 a11 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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Applicant Permitee Signature Date Issue Signature Date
Patrieia Bourgeois Ext692 (2/3) 08/30/2016 08: 13:48 AM -0500
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FOR C USE ONI.Y
���0 P.0 gox Oroao Dace Rece ����Permit#1�4J�1U� +v�
2750 Kelley Parkway
Crystal Bay,NIN 55323 Approved By:(Tf Required):
(952)249-4600
S �
F�9kFSH���G CITY OF ORONO—WATER METER FORM
(Note:Some permiu ma}requiro approval by the Building Official and/or Public Works Department)
GENERAL INFORMATION
1. WATER METERS must be picked up an�paid for at City Hall.
2. If possible,fax in this application ahead of time;we will then cal]you and let you know we have
the water meter in stock. Fax Number:(952)249-4616. Also,you can call ahead of rime to make
sure we received the fax,or to wam us thAt the fax is coming.
3. WATER ME;TERS must be set and sealed by Orono Water Department (952) 249-46Q0,
upon comptetion of ineter installation.
TYPE OF PF,RMTT
Check.AII That A 1
❑Residential(May Requirc Approval) ❑Commercial(Approval Rec{u'uecl)
New Meter ❑Additional Meter—For: ❑Replacement Meter
�
Job Site/Owner Information:
Site Address: ��-3� ��S C... �Q..
�,
Owner: ��e�\1�.5�Ccxr�. �.rc�,�.,t \lU,^�w� Mailing Address:
City: Zip:
Iiome Phone; Alteniate Phone:
Contractor Information:
Contractor: '�1 C �V�C�\(xn,Cc�� �,Y'�,,(:ontact Person: DJ�`�t},5
Address: ,1e�}11 ��¢rr E1 C\ �-�l� State License#: C`p��"J�J�j�
City: �(��`�L�.�__ ��P�k� Expiration Date: I 2-�J� �[�
Phone: ���a_�_��-�} Alternate Phone:
Patricia Bourgeois Ext692 (3/3) 08/30/2016 08: 14;24 AM -0500
.
� ; , � ,WA�E� ,�T�R���a,����'��� r �
' �., .�LY.$�`��,'��A�'ET)��`'i'rGIjPY�TAFF` r
❑ 5/8"METER- 3/4"METER- ❑ 1"ME'T�R-
❑ 5/8"HORN - 3/4"HORN - ❑ I"HORN -
❑ "WATER METER ('fHESE WILL HAVE TO BE SPECIAL ORDEiiED&PRICES DETETtMINED)
1. METER FEE: $
2. HORN FEE g ��
3. TOTAL PERMIT FEE(Add Lines l-2 Above) $
� CITY-USE ONLY
* For Current Pricing Refer to C:urrent Year-Water Meter Pricing Chart*
BRAND:
SIZE: ❑ 5/8" �3/4" ❑ 1" ❑Other "
SERIAL#: S�31 �'7 �� C ��� /_/�D
1 $ J�, �v w
ERT HIGH#t: (if applicable)
ADDITI�NAL INFORMATION—WATEI2 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, d certifies that all statements made on this application are,tr�ue and correct.
Applicant: Date:�� �L.p � �
.�
Original.• 1-Address File
Make.C.opies For: 1-Utiliry BilCing Department
I \� � � l�
�� �---�� DATE TIME
CITY OF ORONO cnLLED IN � � ��
iNSPECTION N TICE �?� SCHEDULED �- -/ /�•'�
PERMIT NO. �l �d-�`� �MP ED �
ADDRESS
O'WNER TE PHONE NO. �� - �� � ���
CONTRACTOR �
4�� DESCRIPTION
j ❑ FOOTING ❑ DEMO-FINAL ❑ SE TIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLIN(i
O ❑ FOUNDATION WATERPROOF��LUMBING FINAL ❑TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMINC, ❑ 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
_
v ❑ DEMO-SITE ❑ SEPTIC INSTALL
2 01MN�RACTOR TO MEET Y�U:_YES_NO
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W ❑WORK SA7ISFACTORY:PROCEED ❑PFiOJECT COMPLETE
� ❑ppqqECT Wpfp(d PROCEED ❑ISSUE CERTIRCATE OF OCCUPYINCY
0 D CORRECT YMORK,CALL FOR REINSPECTION TEMPOFIARY
V BEFORE CWERINO PEqMANBdT
O ppqqECT UNSAFE OONDITION WITHIN H��. ❑p►{pT0 TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑pTATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRAN(iE ACCESS.
csN tor u�e next inspection 2a nours�n ad�ranoe. (952� 249-4600
on site:
inspector.
WMN CopyAnapactw's FlI� C�n�ry CoP1�►SIN Notia