HomeMy WebLinkAbout2015-01571 - water meter CITY OF ORONO * z 0 1 5 - 0 1 5 7 1 *
2750 KELLEY PARKWAY DATE ISSUED: 12/18/2015
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 761 BRIDGEWATER DR
PIN : 33-118-23-12-0092 j� �
LEGAL DESC : STONEBAY SEVENTH ADDITION ��.� c��'�
: LOT 5 BLOCK 1 / C�
PERMIT TYPE : WATER METER-RESIDENTIAL J
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
5/8"NEPTUNE WATER METER
SERIAL#94069727
ERT HIGH# 1850421059
WATER METER RESIDENTIAL HORN 1 WATER METER RESIDENTIAL 1
APPLICANT WATER METER RESIDENTIAL 242.65
SCHULTIES PLUMBING WATER METER RESIDENTIAL HORN 80.42
1521 94TH LANE NE TOTAL 323.07
BLAINE, MN 55449 Payment(s)
(651)786-4007 CHECK 33480 323.07
Minnesota State License#: plbg-058799PM,mech-MB005379
OW1vER
Stonebrook Development LLC
17149 LINCOLN ST NE
#600
HAM LAKE, MN 55304-
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 requices 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 cons[ruction 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. �
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Applicant Permitee Signature Date Issued By Signature Date
12/17/2015 09:57 7632592299 SCHULTIES PLUMBING PAGE 62/07
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���'�� sHo�a��� CITY QF OR�NO--WATER]►�ETER FORM
(1Vote;Somc permj(g may requiTc aPprovaf hy the Building Qfficial nnd/or Public Wprks Dcpartment)
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1. WAT'�R ME'['�RS musc be picke(1 up and pRid for at City HRII.
2. I�q�s�'b1e,fa�c in this application ahcad of fimc;we will the�cal]you�utd let you know wve havC
the w�er metcr in stoCk. F'ax Numbe�: (952)249-4616. Also,ydu can Call ahead of time to make
sure we receiv¢d the fax,or to warr,us that the�Ax is coming.
3. WATER M�TERS �nus� be set �nd sealed by brono Water DcpArtme�t (952) 249-4600,
upon eompletion of ineter iastallatxon.
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(�Residentisl(May Require Appro�ttl) ❑Commcrciai(Approval Rcqaired)
,�,.New Metcr ❑Additiona!Meter—For� ❑Replaccment Metcr
'�'��'a��t�t�C�r�'t�ri Z���+r'm�Ct�.
Site A,ddress: "
Owrler Mailing fl,ddress: �/ ��������
City:
Zip:
Home Phone: �`�. Allernate Phone: '"-- �
'�`u�h�i�t�il',,Tr�'�rt`�ti��t�i`i�r ` , ,
Contractor: ' COt]tact PEtSon: �
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Address: State License#: /��,�:
C��3'= ` Zi}�� Expiration Datc: � o�-�`
Phone: 7�3���� Alternate Phone: �$
12/17/2015 09:57 7632592299 SCHULTIES PLUMBING PAGE 03/67
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5/8"MET$�t- ❑ 3/4"MF'TER- ❑ 1"METF,R-
5/S"HORN - ❑ 3/4"HORN �
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lJ �'�'WATER MET�R ('TITI;SE WTf,L ii11VF:'�'O B�i$p�t,'Ul.p�DER�;A&PRICES DTyT�RMIN�b)
1. METER FEE: �
2. HOR'V FE� $
3. TOTAL�ERM1T FEE(Add Lines 1�2 Above) �
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* For Current Pricing Refer to Current Year T Water Meter Pricing Chart *
E3RAND� �
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s����#: _ II I I I I r��i�ll II I I IIII i�III III Ifl
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ERT HiC,H#: _ 1850421059 (if applicable)
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The undersigncd hereby applies to tlie City of Orono for rssuance of a water rneter permit,agrees
to do all work in strict accordance with the ardinances of the City and the regulations of the State
of Mintlesota,and certifies that ali statements made on this applicataon are,tnie and correct.
�.pplicant: bate:�r�����/�=���
Original: I-Address Fi[e
Make Copie.s f+or, 1- (Jlilifiy Billi�g Departrraerrt
���. SC'��--f
DATE TIME
CITY OF ORONO CALLED IN i� yY�
INSPECTION NOTICE �, � SCHEDULED
PERMIT NO. =�l`,(C�`�I�-� COMPL ED
ADDRESS � � ��i �:��-C�.�� �� � �) ,
OWNER TELEPHONE NO.�'�l (a Z7���I�C�
CONTRACTOR � L-��� C�I C,���_�
� DESCRIPTION �� � ��
t� ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
_ ❑ AS BUILT-SURVEY ❑ S WER HOOK-UP ❑ FOUNDATION/REMOVAL
J ❑ DEMO-SITE ❑ S IC INSTALL
2 OWNERICONTFiACTOR TO MEET YOU: YES_NO
v�, COMMENTS:
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W �WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
� ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
O CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR O CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call forthe next inspection 24 hours in advance. (952� 249-4600
OwnerlContractor on site:
Inspector. ��
White Copyllnspector's File Cenary CopylSite Notice