HomeMy WebLinkAbout2016-00102 - water meter _ CITY OF ORONO * z 0 1 6 - 0 0 1�
' 2750 KELLEY PARKWAY DATE ISSUED: 02/OU2016
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 664 SANDSTONE CIR
PIN : 33-118-23-11-0058
LEGAL DESC : STONEBAY
: LOT 009 BLOCK 002
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
SERIAL#1540081880
ERT#68506710
WATER METER RESIDENTIAL HORN 1 WATER METER RESIDENTIAL 1
APPLICANT WATER METER RESIDENTIAL 242.65
WATER METER RESIDENTIAL HORN 82.02
PRECISION PLUMBING&HEATING INC. TOTAL 324.67
4124 MACKENZIE CT
ST. MICHEAL, MN 55376 Payment(s)
(7(3)497-7486 CREDIT CARD 7719 324.67
Minnesota State License#: plbg-PC643806,mech-MB004099
OWNER
Stonebay Builders LLC
14870 BROCKTON LANE
DAYTON, MN 55327-
AGREEMENT AND SWORN STATEME1vT
The work for�vhich this permit is issued shall be performed according to
the approved plans and specifications,applicable Ciry 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 I80 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.
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� y Applicant Permitee Signature Date Issued By Signature Date
FOR CITY USE ONLY
��� City of Orono .�(��� �� � �
O P.O.Box 66 Date Received: �� ��' Permit# '�'r
2750 Kelley Parkway
Crystal Bay,MN 55323 Approved By:(IfRequired):
(952)249-4600
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`�kFSH�R�G 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 far 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 ineter installation.
TYPE OF PERMIT
(Check All That A 1
�Residential(May Require Approval) ❑ Commercial(Approval Required)
)
�ew Meter ❑ Additional Meter—For: ❑ Replacement Meter
Job Site/Owner Infonnation:
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Site Address: ,.� �-►^- ti-�- � � /�
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Owner: Mailing Address:
City: Zip:
Home Phone: Alternate Phone:
Contractor Information:
Contractor: /!�«lS�o� �1��� r�+ Contact Person: �/�����-�--
Address: 7l�� f��a?r�- c�`ti�State License #: �C �����
City: .�I'Tc��� Zip�� ExpirationDate: �� " r "�
r
Phone: '7�c3��'f 7- 7�Q� Alternate Phone: ����4 7- 7�
WATER METER PERMIT FEES
WILL BE CAULULATED BY CITY STAFF
,�5/8"METER- ❑ 3/4"METER- ❑ 1"METER-
5t8"HORN - ❑ 3/4"HORN - ❑ 1„HORN -
� "WATER METER (THESE W1LL 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 Cunent Pricing Refer to Current Year - Water Meter Pricing Chart *
�
BRAND: � .-��. _�/�.. /L-��-' ..
SIZE: �] 5/8" ❑ 3/4" ❑ 1" ❑ Other "
�\ 5/8 x 3/4
SERIAL#: � unimnimnniiiwinn 68506710
ERT HIGH#: isaoos,aso (if applic< �IIIII�It�I�II��IIIIIIIItIIIIIIIIIIIIIIIIIIIIIIIIIII
ADDITIONAL INFORMATI4N—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.
Applica • ` Date: �� �� � � ��
Original: 1-Address File
Make Copies For: 1- Utility Billing Department
�
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TIME�
CITY OF ORONO CALLED IN - � �
INSPECTION NQu� ��D�HEDULED � —
PERMIT NO. ��EJ PLETED
ADDR
OWNER ELEPH / ��9J�
CONTRACT r�
� DESCRIPTION � ��
t~y ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
•'�Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
� ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
_ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
J ❑ DEMO-SITE ❑ SEPTIC INSTALL
2 01MNERICONTRACTOR TO MEET YOU:_YES_NO
c� COMMENTS:
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� ❑WORKSATISFACTOFlY:PROCEED �OJECTCOMPLEfE
� ❑CORRECT YNORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECdVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHpTO TAKEN
INSPECTOR YVILL RETIJRN
❑STOP ORDER POSTED.CALL INSPECTOR ��TATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for tl�e next inspection 24 hours in advance. (952) 249-4600
OwneNContractor on site:
inspector:
Whits CopyMnapectw's Fik Canary CopylSiM Notice