HomeMy WebLinkAbout2017-01652 - water meter � . �
CITY OF ORONO * z � 1 7 - 0 1 6 5 2 *
2750 KELLEY PARKWAY DATE ISSUED: 12/26/2017
ORONO, MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS : 725 STONEBAY DR
PIN : 33-118-23-11-0069
LEGAL DESC : STONEBAY THIRD ADDITION
: LOT 002 BLOCK 001
PERMIT TYPE : WATER METER-RESIDENTIAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER METER-RESIDENTIAL
NOTE: INSEPCTIONS ARE DONE BY PUBLIC WORKS DEPARTMENT.
TO SET-UPAN INSPECTION,PLEASE CALL:(952)249-4613
5/8"NEPTUNE WATER METER
1540097894
68506704
WATER METER RESIDENTIAL HORN 1 WATER METER RESIDENTIAL 1
APPLICANT WATER METER RESIDENTIAL 242.65
SCHULTIES PLUMBING WATER METER RESIDENTIAL HORN 82.02
1521 94TH LANE NE TOTAL 324.67
BLAINE,MN 55449 Payment(s)
(651)786-4007 CHECK 34100 324.67
Minnesota State License#:plbg-PC644177,mech-MB005379
OW1vER
Wooddale Builders
6117 BLUE CIRCLE DR, SU[TE 101
MINNETONKA,MN 55343-
AGREEMENT AND SWORIv 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 sepazate
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 are
requested in conformance with the State Building Code.This pertnit may be
revoked at any time for due cause.
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icant erm' e Si ature Date Iss By Signature Date
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FUR G'7"1"'�'t1SE QNLY
��A y� City of Orono
i d P.O.Box 66 Date Rec�ive,cl: Pettnit#
2750 Kelley Parkway
Crystal Bay,MN 55323 Approved By:(If Required):
(952)249-4600
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C'��fsxo�``� CITY OF ORONO-WATER METER FORM �
(Note:Some permits may require approval by the Building Official and/or Public Works Department)
GENE�.AL INF(}RMATI(�N
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 faac is coming.
3. WATER METERS must be set and sealed by Orono Water Department (952) 249-4600,
upon completion of ineter installation.
; TXFE C!F PERM�`�'
Ch��AlI Th�t A' 1
�Residential(May Require Approval) ❑Commercial(Approval Required)
�New Meter ❑Additional Meter—For: ❑Replacement Meter
dt�b�i�/()wri�z�i�f'Utx'Yiatian:
Site Address:
Owner• ailing Address: �!/
City: i��i(�n>.1�t��� Zip: _S�y 7
Home Phone: �,�-��''dJ� Alternate Phone:
Co�t�c��Ir�f�r�nati�a: '
Contractor: Contact Person:
Address: � te License#: � L����
City: � Zip:����Expiration Date: � o�
Phone: 71v�7'"7�5�—�� Alternate Phone:
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WATER METER��PEkMIT F��S� ���
WILL B�; CAU'I,I�LATEi�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 BF,SPECIAL ORDERED&PRICES DETERMINED)
1. METER FEE: $ �� �� ��
2. HORN FEE $ p�• O �
3. TOTAL PERMIT FEE(Add Lines 1-2 Above) $ -3"2LI a �,r 7
CITY-USE ONLY
* For Current Pricing Refer to Current Year- Water Meter Pricing Chart *
BRAND: I�LF.���� � sis X�a
68506704
SIZE: �/8" ❑3/4"` ❑ 1" ❑Other I�III tIIII IIIII tl I II I IIIII II��I II I I t II
SERIAL#: ��-�D�P �G
ERT HIGH#: ��5�j(�O �l 7�`f� (if applicable)
III II IIIII I III II II III IIII II11
1540097894
ADDITIONAL INFORMATION—WATER METERS
The undersigned hereby applies to the City of Orono for issuance of a water meter permit, agrees
to do all wark in strict accordance with the ordinances of the City and the regulations of the State
of Minnesota, and certifies tl� ll statements made on this application are,true and correct.
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Applicant: Date: � �
Original: 1-Address File
Make Copies For.• 1- Utility Billing Department
DATE TIME •
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED -��-/� ��0
PERMIT NO.G��t?�d/��S� COMPLETED
ADDRESS .5 � �''�
OWNER TELEPHONE NO. ��5���30
CONTRACTOR .����/l�/raS
� DESCRIPTION �� v�- .��A
� ❑ FOOTING ❑ PLUM8ING FINAL O EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORFJWETLANDS
� ❑ FRAMING ❑ MECHANICAL FINAL
❑ TREE REMOVAL
Z O INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
� ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
c�i, COMMENTS:
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� ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CAIL FOR REINSPECTION TEMPORARY
V BEFORECOVERINCa PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL REfURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Ca11 for the next inspection 2a hours in advance. (952� 249-4600
OwnerlContractor on site:
Inspector.
White Copyllnspector's File Canary CopylSite Notiee