HomeMy WebLinkAbout2015-01022 - water meter CITY OF ORONO 1111111 IN Hill 1111111111111111111 gill gum
* 2015 - 01022 *
2750 KELLEY PARKWAY DATE ISSUED: 08/12/2015
ORONO,MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS : 3740 NORTHERN AVE
PIN : 17-117-23-34-0088
LEGAL DESC : REG.LAND SURVEY NO.0763
LOT 2 BLOCK 1
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"WATER METER
SERIAL NUMBER-52155578
ERT HIGH#1831447970
WATER METER RESIDENTIAL HORN 1 WATER METER RESIDENTIAL 1
APPLICANT WATER METER RESIDENTIAL 294.42
WATER METER RESIDENTIAL HORN 80.42
NORTH ANOKA PLUMBING TOTAL 374.84
22590 RUM RIVER BLVD.N.W. Payment(s)
MN 55070- CREDIT CARD 7809 374.84
(763)753-3373
Minnesota State License#:plbg-PC642884
OWNER
Real Assets II,LLC
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 all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
i?o
Applicant Petmitee Signature Date Issued y S gnature Date
[ .4
R C V VSE ONLY
City of Orono oma'
P.O.Box 66 DateReceM Permit# aO 1S
�./ 2750 Kelley Parkway
Crystal Bay,MN 55323 Approved By:(If Required);
(952)249-4600
CITY OF ORONO-WATER METER FORM
(Note:Some permits may require approval.by the Building Official and/or Public Works Department)
GENERAL IN ORMATION
I. WATER METERS must be picked up and paid for at City Hall.
2. Uggssibl,e 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 meter installation.
TYPE OF PERMIT
Check All That A l -
Residential(May Require Approval) ❑Commercial(Approval Required)
New Meter ❑Additional Meter—For: ❑Replacement Meter
JJoob,'Sitc,C O...Vmer Information:.
Site Address: ® 0►--�°`k4-r'n R� �5e'5
�°� � � LLQ.,
Owner: Mailing Address: S So ZSR r V
City: Zip: Sf- Cto L*- IVIKD
Horne Phone: Alternate Phone: ---�
Contractor Information:
N r ACV,*k...A— � J
Contractor: p( l i T—i c . Contact Person: v� �. 1•,S e�,^�,
�. -set o iz V" 1z,,-e, g
Address: State License#: P C_ l0 4 2-ir T-j
City: Zip:LoJ Expiration Date: n- 1%!r
Phone: �? �'3 -1 3-3 11'41 Alternate Phone: L 11...-L t) -1 d 3'7
5/8"METER- N 3/4"METER- ❑ 1"METER-
5/8"
ETER-
5/8"HORN - 7,3/4"HORN - ❑ 1"HORN -
❑ "WATER METER (THESE WILL HAVE TO BE SPECIAL ORDERED&PRICES DETERMINED)
1. METER FEE: $
2. HORN FEE $ w0, /V
3. TOTAL PERMIT FEE(Add Lines 1-2 Above) $ ,
CITY-USE ONLY
*For Current Pricing Refer to Current Year-Water Meter Pricing Chart
BRAND:
SIZE: ❑5/8" [,33/4" ❑ 1" ❑Other
SERIAL#: JQ/SS.-7k
ERT HIGH#: / Y,31 yq 2 9 70 (if applicable)
ADDI4NAL INFGRMATION—MATER METERS
The undersigned hereby appliestothe 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,andce ' les that all statements made on this application are,true and correct.
Applicant: Date:
Original: I-Address File
Make Copies For: I-Utility Billing Department
C f 5.0
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE Z� SCHEDULED Z 461
PERMIT NO.o;1D l COMPLETED
ADDRESS 7 O �r`f P'1
OWNER TELEPHONE NO.
CONTRACTOR Y�o
DESCRIPTION /% '�` �
W ❑ FOOTING ❑ DEMO-FINAL ❑ SEP FIN L
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
❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
r ❑ DEMO-SITE ❑ SEPTIC INSTALL
Q OWNERICONTRACTOR TO MEET YOU:_YES_NO
Z
COMMENTS: 1"61IJ-d '1
W
a
W
Cc
Q
W
Z
Uj
Cc
Ove 5 6vv�
W ❑WORK SATISFACTORY:PROCEEDPROJECT COMPLETE
W
❑CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
C1 BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR El CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contractor on site: /
Inspector. )E
White Copy/inspectoes File Canary Copy/Site Notice