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Home My WebLink About2016-00733 - water meter CITY OF ORONO * 2 P1 1 6 - 0 PJ 7 3 3 * 2750 KELLEY PARKWAY DATE ISSUED: 06/23/2016 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 787 BOULDER DR PIN : 33-118-23-11-0132 LEGAL DESC : STONEBAY : LOT 7&8 BLOCK 1 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 5/8"WATER METER SERIAL NUMBER 68506709 ERT HIGH# 1540103380 WATER METER RESIDENTIAL HORN 1 WATER METER RESIDENTIAL 1 APPLICANT WATER METER RESIDENTIAL 242.65 WATER METER RESIDENTIAL HORN 82.02 SCHULTIES PLUMBING TOTAL 324.67 1521 94TH LANE NE BLAINE,MN 55449 Payment(s) CHECK 33642 324.67 (651)786-4007 Minnesota State License#:plbg-PC644177,mech-MB005379 OWNER PIERCE FAM TRUST,MARY SUE 5491 ANDERSON ESTATES RD MAPLE PLAIN,MN 55359- 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 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 permit may be revoked at any time for due cause. ,_ �� -P � � / Applicant Permitee Signature Date [ssued B ignature Date FOR CITY USF,ONLY City of Orono �-Q�� P.O.E3ox 66 Date Received: ✓� /kPermit# ZC�� `L'L'� 7�3�� 2750 Kelley Parkway c� Crystal E3ay,MN 55323 Approved By:(If Required): �.�/ (952)249-4600 a a Z h � L� �,,x�sH�� CITY OF ORONO—WATER METER FORM (Note Some permits may reyuire 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,faac in this application ahead of time;we will then call you and let you know we have the water meter in stock. Fas 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 Job Site/Owner Information: � Site Address: 7� % �`'�"�` '��'' �./'' c�t' � % �..�� .�� ' � Owner: ,t�r �_c>_�z� a.�i' Mailing Address: G:✓/� ,E,Ycr.� _C��v,�� Ci d%// /�" Zip: �r5�� Home Phone: �-„2�'��'`,�'�'�� Alternate Phone: Contractor Information: Contractor: .�.�,� ,lr�i/�'�C�a-� Contact Person: '' , --, , Address: /` � i�C� State License#: p C_ Sl�� , ' City: �-�-��_._- Zi�� Expiration Date: �� Jl��/�� Phone: j�?5"��>��/ Alternate Phone: . WATER METER PERMIT FEES WILL B�C�AULULATED BY CITY STAFF ,� 5/8"METER- ❑ 3/4"METGR- ❑ I"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: sie X 3i4 68506709 SIZE: ❑ 5/8" ❑ 3/4" ❑ 1" ❑ Other " II l�II III I I II II II I�II I II I SERIAL#: ERT HIGH#: (if applicable) III II IIIII I IIII I II I IIIIII I III 1540103380 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 accardance with the ordinances of the City and the regulations of the State of Minnesota, and certifie at all statements made on this application are,true and correct. -�� ^� Applica • Date: � �'"��li� Original.• 1-Address File Make Copies For: 1- Utility Billing Department DATE TIME CITY OF ORONO CALLED IN -'`�� INSPECTION�OaTJCE�.,33 SCHEDULED � � PERMIT NO. �� COMPLETED ADDRESS � � OWNER ELEPHONE NO. �2��S�'3� CONTRACT�R �-�`�-� � � DESCRIPTI�`�� c,-�'-� ��"��( ly ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL �LUMBING 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 �4 ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL _ J ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 OWNERlCONTRACTOR TO MEET YOU:_YES_NO � � COMMENTS: 1�1 �°i�"�✓' /✓+� II�� a ��' �-ar-�.�CS �T�� S � J O �. � O � W � Q � 2 W � W � 1 � d W O WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN INSPECTOR WFLL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call forthe next inspection 24 hours in advance. (g52) 249-46�� OwnerlContractor on site: Inspector. �_� White Copyllnspector's File Canary CopylSite Notice