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Home My WebLink About2017-00181 - water meter CITY OF ORONO * z 0 1 7 - 0 0 1 8 1 * ^� 2750 KELLEY PARKWAY DATE ISSUED: 02/24/2017 ` ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 2000 SHADYWOOD RD PIN : 17-117-23-31-0001 LEGAL DESC : GUST S JOHNSONS ADDN : LOT 000 BLOCK 000 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 [NSPECTION,PLEASE CALL:(952)249-4613 WATER METER RESIDENT[AL HORN 1 WATER METER RESIDENTIAL 1 APPLICANT WATER METER RESIDENTIAL 372.06 WATER METER RESIDENTIAL HORN 144.64 CARLSON PLUMBiNG TOTAL 516.70 19240 ISETTA ST NE Payment(s) EAST BETHEL, MN 55092- CHECK 6930 516.70 (651)291-7788 Minnesota State License#: plbg-PM062270 OWNER Sustainable 9 Holdings LLC 124 MAIN ST SE SUITE#343 M[NNEAPOLIS, MN 55414- 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 rype 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 l80 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 i ' g qde.This permit may be revoked at any time for due cause. `� / � ��q� � ��,c.�; � �� ,_��-��. � �� - Applic ermitee Signature Date [ssued By Signature Date ..r. . FOR CITY USE ONLY City of Orono �O� P.O.Box 66 Date Received: � Z`'��Permit# �(�� `� � 2750 Kelley Parkway Crystal Bay,MN 55323 Approved By:(If Required): �� (952)249-4600 y �. Ci iC C:-�S`3 �% � � ��'�ESH��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 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. TI'PE OF PERMIT Check All That A 1 �'Q Residential(May Require Approval) ❑Commercial(Approval Required) r � ,�f New Meter ❑Additional Meter—For: ❑ Replacement Meter �� L Job Site/Owner Information: Site Address: � C>C�� % S G�c� (�� t.,J �.�-%C� Owner: Mailing Address: City: �i(�U ��- �% Zip: Home Phone: Alternate Phone: Contractor Information: ' ' /s�� Contractar: C�, ,�(,s�,� ��-,.�'�Contact Person: � � �� d� �' � Address: 1�,,� �/v S� T`t�2 S �tate�icense#: - c� G City: �`�.j� �E' �"�'-°-'� ZipS,�Expiration Date: � �- �/ �- �� (S( �`1/- ]7�f Phone: ) Alternate Phone: .-- WATER METER PERMIT FEES WILL BE CAULULATED BY CITY �TAFF ❑ 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 1-2 Above) $ �� " �� CITY-USE ONLY * For Current Pricing Refer to Current Year - Water Meter Pricing Chart * BRAND: SIZE: ❑ 5/8" ❑ 3/4" 1" ❑ Other " � SERIAL#: � �� L� �� j C�� ' ERT HIGH#: iuiuiiuuinmiiiiuiuii (if applicable) — 1541835326 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 st ements made on this application are,true and correct. Applicant: Date: ,� �'a J � l � Original: 1-Address File Make Copies For: 1- Utility Billing Department ��s � � DATE TIME � / CITY OF ORONO CALLED IN � INSPECTION NOTICE SCHEDULED � � � ___��N PERMIT NO. �r, f�-r:r�: I�'I coMP�ereo ADDRESS � ` � � OWNER TEL�PHONE O. �l"'�/" 7�IG 7� CONTRACTOR �� /i� ` �� q�?�� c� "� DESCRIPTION _ � 1' � ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL ' �� ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING O ❑ FOUNDATION WATERPROOF �PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB �❑�AECHANICALRI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP 41 ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL J ❑ DEMO-SITE ❑ TIC INSTALL 2 O'WNENCONTRACTOR TO MEET Yi0 ' YES_NO y COMMENTS: � '� ,-�-�=� c��vr��a � S � � .� ��-- .� �� r��, v� ��,�� 0 Q �. 15 y� � �� C- � � ?",,�n �,,;; -e� �� ;� - � �_ 7 W � _ � W ❑WORK SATISFACTORY:PROCEED Ct PROJECT COMPLETE � ❑CORRECT WORK�PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑WRRECT WORK,CALL FOR REtNSPECTION TEMPORARY V BEFORE CONERING PERMANENT ❑CORRECT UNSAFE CONDITION WRHIN HOURS. p pHOTO TAKEN INSPECTOR WlLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REW IRED.CALL TO ARRANGE ACCESS. Ca8 for the next inspection 24 hours in advance. (952) 249-46�� OwnedContractor on site: inspector: ��`'��'�-+� Whits CopYAnsPecMr'a Flle C�nary CopYlSks Notke