HomeMy WebLinkAbout2015-01348 - water meter ~ CITY OF ORONO
� 2750 KELLEY PARKWAY * � 0 1 5 - 0 1 3 4 8 *
DATE ISSUED: 10/19/2015
ORONO, MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS : 683 SANDSTONE CIR
PIN : 33-118-23-11-0043
LEGAL DESC : STONEBAY
: LOT 040 BLOCK 001
PERMIT TYPE : WATER ME1'ER-RESIDENTIAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTIOIv TYPE : WATER METER-RESIDENTIAL
NOTE: INSEPCTIONS ARE DONE BY PUBLIC WORKS DEPARTMENT.
TO SET-UP AN INSPECTION,PLEASE CALL:(952)249-4613
5\8"NEPTUNE WATER METER
SERIAL NUMBER 68159558
ERT HIGH 185298821
WATER METER RESIDENTIAL HORN 1 WATER METER RESIDENTIAL 1
APPLICANT WATER METER RESIDENTIAL 242.65
WATER METER RESIDENTIAL HORN 80.42
PRECISION PLUMBING&HEATING INC.
4124 MACKENZIE CT TOTAL 323.07
ST. MICHEAL,MN 55376 Payment(s)
(763)497-7486 CREDIT CARD 7760 323.07
Minnesota State License#: plbg-PC643806,mech-MB004099
OWNER
Stonebay Builders LLC
14870 BROCKTON LANE
DAYTON, MN 55327-
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 goveming 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 aze
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
'1 -
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�' ' Ol � :%�o ��--Lt���� - ��� t 7� /S
A pl' nt ermit e Signature Date Issued B ignature Date
FOR CITY USE ONLY
�O A' City of Orono
1 y P.O.Box 66 Date Received: Permii#
� 2750 Kelley Pazkway
Crystal Bay,MN 55323 Approved By:(If Required):
(952)249-4600
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�qkFSH�4�C' CITY OF ORONO—WATER METER FORM
(Note:Some permits may require approval by[he 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 ineter installation.
TYPE OF PERMIT
(Check All That A 1 �) �
❑ Residential (May Require Approval) ❑ Commercial(Approval Required)
�New Meter ❑Additional Meter—For: ❑ Replacement Meter
a�
Job Site/Owner Information:
Site Address: ���� ��t�/lDt, (�,I�'
Owner: �WY�b� �°X�.�P1�n�,o,�� Mailing Address:
City: ���I(1,1� Zip:
Home Phone: Alternate Phone:
Contractor Information:
Contractor: �p����UW�� Contact Person: 0(�
�
Address: �(2"� ���,�1'1i�C.v, State License #: �V�0�J�� 1�
�
City: l Zip: 1�J3�b Expiration Date: Z� �i � �� �
Phone: 7�O� `'r�7• 7`E�� Alternate Phone:
WATEI�METER PERMIT FEES
WLL,L BE CAULULATED BY CITY STAFF
❑ 5/8"METER- ❑ 3/4"METER- ❑ 1"METER-
❑ 5/8"HORN - ❑ 3/4"HORN - ❑ 1"HORN -
� "WATER METER (THESE WILL HAVE TO BE SPECIAL ORDERED&PRICES DETERMINED)
1. METER FEE: $
2. HORN FEE $
3. TOTAL PERMIT FEE(Add Lines I-2 Above) $ � � �� v�
CITY-USE ONLY
* For Current Pricing Refer to Current Year - Water Meter Pricing Chart *
B�rrD: �--
s,s X sia
SIZE: � 5/8" ❑ 3/4" ❑ 1" ❑ Other " 68159558
. ( I IIIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIII IIII
SERIAL#.
ERT HIGH#: _ III III II18I5129I88I1I�1�IIIII (if applicable)
ADDITIONAL INFORMATION—WATER METERS
The undersigned hereby applies to the City of Orono far 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: l� � I l� 2���
Original: 1-Address File
Make Copies For: 1- Utility Billing Department
i
Monica Fadness
From: Scott Oberaigner
Sent: Tuesday, November 10, 2015 3:13 PM
To: Monica Fadness
Subject: 683 Sandstone
The water meter set and seal is done at address above.
Scatt Oberaigner
�St�li�y Supervis�sr
City af{�roncr
952-249-4500 mairs �5�-�49-46�€�ciirect.
soberaigner@ci.orono.mn.us
1
` �i CITY O� ORONO Service0rderNumber .
SERVICE ADDRESS DUE DATE:
/„ Q� 5�,��s�v y .� APPT TIME:
V v
CUSTOMER� BILLING HOME PHONE:
BILLING WORK PHONE:
ACCOUNT NUMBER BOOKlSTOP:
0-0
DATE/TIME CREATED CALL TAKEN BY:
�
Requested By:
NATURE OF WORK ORDER "
��-� � s���
Final Billing Address(Info): Forwarding Address New Customer Information:
Address: Name: __ __ ____.—._....
City: Mailing Address: _ __ _ __ _
State: —_
Zip: Phone: _ ----
READING INFORMATION Service Number: 10=Water 20=Deduct Mtr
CURRENT METER SIZE MAKE SERIAL NUMBER LAST READING DATE
Service Number: Date InS�lled: ERT ID LAST METER.READING
" S- �8S� q�F'�j/`,z I
v CURRENT READING
U
SIZE MAKE SERIAL NUMBER CURRENT READING
METER REMOVED
ERT ID �da�/'Z��
Service Number:
� inventory
� Junked
I
I SI�E MAKE SERIAL NUMBER NEW STARTING READ
METER INSTALLED
Service Number: Date fnstalie@: ERT ID
❑
Deduct Meter I I
REMARKS:
❑ Update S/Q
Date Compfeteci: �//Ol�� SIGNED: � I� Update inquiry