HomeMy WebLinkAbout2011-01472 - water meter CITY OF ORONO PERMIT NO.: 2011-01472
2750 KELLEY PARKWAY
ORONO,MN 55356- 5 ISSUED: 11123/2011
(952) 249-4600 FAX: (952)249-4616 ANN
ADDRESS 450 OLD CRYSTAL BAY RD N
PIN : 33-118-23-13-0017
LEGAL DESC : CRYSTAL BAY BUSINESS CENTER
: LOT 001 BLOCK 002
PERMIT TYPE : WATER METER
PROPERTY TYPE : COMMERCIAL-BUSINESS
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 I WATER METER RESIDENTIAL
APPLICANT WATER METER RESIDENTIAL 245.70
VOSON PLUMBING INC. WATER METER RESIDENTIAL HORN 68.97
1515 A 5TH STS TOTAL 314.67
HOPKINS,MN 55343
(952)938-9300
Minnesota State License#: 677445-PM
OWNER
RYAN COMPANIES US,INC.
50 SOUTH 10TH.STREET SUITE
MINNEAPOLIS,
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. /L/
Applicant Permitee Signature Date Issued By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
Sik
44111 AiN
FOR CITY US
,¢d�0 City of Orono
P.O.Box 66 Date Received: Permit#
ti 2750 Kelley Parkway
,'' I Crystal Bay,MN 55323 Approved By:(If Required):
44,144,
o (952)249-4600
�"�rzes CITY OF ORONO—WATER METER FORM
(*Note: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 possible, 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 Apply)
❑ Residential (May Require Approval) 'Commercial(Approval Required)
New Meter Additional Meter—For: 13 Replacement Meter
Job Site/Owner Information:
Site Address: 75 o//2 C lfc/W'`' /3/1-7 /2d
Owner: 2yu, 1 (1� Ctt/� ✓1I(S Mailing Address: .� .. !64 Sr
City: lrn Zip: 51 -I&)
Home Phone: / a gga— (ICUU Alternate Phone:
Contractor Information:
Contractor: \O.SC,v\ irythit) Contact Person: 1444c \lis
Address: [Pr her State License #: y-15
!/r
City: 1 Zip:S11-(3 Expiration Date: P77 //Z
Phone: 25"L' C'.)tio Alternate Phone: Z 9Q 135c6
' 9
I'
ATER 1VIETER PERMIT FEES
WILL E CAULULATED BY CITY STAFF_ r ,
5/8"METER- ❑ 3/4"METER- ❑ 1"METER-
5/8"HORN - ❑ 3/4"HORN - ❑ 1"HORN -
cc-/s_
❑ "WATER METER (THESE WILL HAVE TO BE SPECIAL ORDERED&PRICES DETERMINED)
1. METER FEE: $ 95 - 7°
IIJ� r�, -7
2. HORN FEE $ _
/ �r ?
3. TOTAL PERMIT FEE(Add Lines 1-2 Above) $ /
CITY-USE ONLY
* For Current Pricing Refer to Current Year-Water Meter Pricing Chart *
BRAND: -Q p /
SIZE: /8" ❑3/4" ❑ 1" ❑Other
SERIAL#: % 0 Lr ` LP 0 U
ERT HIGH#: III!I!II IIII IIII URN II (if applicable)
1831770697
ADDITIONAL INFORMATION—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: /1/a S/ (7
k•,Reset:Firm
Original: 1-Address File
Make Copies For: 1- Utility Billing Department 1-Cash Drawer