HomeMy WebLinkAbout2016-00297 (water meter) - CITY OF ORONO * Z 0 1 6 — 0 0 2 9 7 *
2750 KELLEY PARKWAY DATE ISSUED: 04/OS/2016
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 3287 CASCO CIR
PIN : 20-117-23-43-0044
LEGAL DESC : WINSHIPS SUBD SPRING PARK
: 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 INSPECTION,PLEASE CALL:(952)249-4613
5/8"WATER METER
SERIAL#68506711
ERT HIGH#154497492
WATER METER RESIDENTIAL HORN 1 WATER METER RESIDENTIAL 1
APPLICANT WATER METER RESIDENTIAL 242.65
WATER METER RESIDENTIAL HORN 82.02
LAKE COUNTRY PLUMBING INC TOTAL 324.67
P O BOX 30
WACONIA, MN 55387- Payment(s)
(952)467-5000 CREDIT CARD 8695 324.67
Minnesota State License#:plbg-PC645455
OWNER
STRUCK,JAN&SARAH
3862 NORTHERN AVE
SPRING PARK,MN 55384-
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 hereia 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 Building Code.This permit may be
revoked�r�time for due cause. _
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Applicant Permitee Signature Dat [ssued B ;Signature Date
Mar 30 16 11:19a Lake Country Plumbing, I 9524675000 p.1
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FO CiTY USE O'_VLY
�O A T Cit}'of Orono ��j �/`���— O��7
1 yO P.O.Box 66 Daie Receick�' it� '�l�
2?50 Kelley Padc�vay
tCrystaf Bay,MN 55323 Approved By:(If Required):
` � (952)�49�600
1 y� �
� ti�' CITY OF ORONO—WATER METER FORM
��ES 4i�Q' (note:Some permils may requim approval'oy the Building Official andlorPublic Wo:ks Departmcnc)
' GENERAL INFORMATIO�I
1. WATER METERS must be picked up and paid for at City Hali.
2. Tf vossib{e,fax in this application ahead of time;r��e will then call you and]et you know we have
the water me4er in stock. Fax Number:(952)244-4616. Also,you can call abead of time to make
sure we received the fax,or to v��arn us thac ti�e fax is coming.
3. WATF.R �iETERS rnnst be set and sealed by Orono �Vater Department (952) Z49-�600,
upon completion of ineter installation.
TYPE OF PERMIT
(Check.All That A i
❑Residential(May Require Approval) 0 Commercial(.Approval Required)
�New Meter ❑ Additional Meter—For; ❑Replaccment Meter
Job Site/Owner Information:
Site Address: �-��7 �r}-S�_E. C'I('C[ � _
O��ner: s T"'''� �� Mailing Address: ��,'�t��
Citv: Z1P=
Home Phone: Alternate Phone:
' Contxactor Information:
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Contractor: �:� ��''�':ti��'"7 �"',�^"`� ContactPerson: � �� � ��!������'Y`�`''�
Address: i��' �'�� ?�` State License+: ��G `.%�`% �y
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City: �,i'�,��-+.��ti' ''� Zip: �J-'�'' Expiration Date: i� '� i ;
Phone: .�i�r.�- -�`1 � J'.�� Alternate Phone: �,15�- '-r�v I ���'c r
Mar 30 16 11:19a Lake Country Plumbing, I 9524675000 p.2
WATER METER PERMIT FE�S
WII.,L BE CAULULATED BY CTTY STAFF
��,'S"MET'ER- ❑ 3/4"METER- ❑ 1„METER-
❑ 5!S"HORN - ❑ �/4"HOR'� - ❑ 1"HORN -
❑ "WATFR METER (THESE WiLL HAVE TO B�SPECIAL ORDERED&PRICES DETERMIN�D)
1. NfETER FEE: �
2. �io[t:*r r�� �
3. TOTAL PER:ti1IT FEE(Add Lines l-2 Above) $
CITY-USE ONLY
* For Current Pricing Refer to Current Year-Water Meter Pricing Chart*
BR�1ND:
sis X aia
68506711
SIZE: ❑5/8" ❑ 3/4'l ❑ l" ❑ Other IIIII��IIIIIIIIIII IIIII I IIIIIIIIIIIIIII��
SERIAL�:
�,RT HTGH#: {if applicable}
I I I I I�I I I�lol I�1 gl I�1419121 I I
ATl1�ITIONAL INFORMATIQN—WATER MET�RS V� � �
Thc ur►dersi��ed 6ercby applies to the City of Orono for issuance of a water rneter permit,agrees
to do all work in strict accordancc with the ordinanccs of the Ciry and the regulatians of the State
of Minnesoca, and certifies that all statennenks made an this application are,true and correct.
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Applicant; ��JJ`- Date: �� ��,�S
—�—�
Origrnal.• 1-Address File
.'l�ake Copies For-: 1- Utility Billing Department
DATE TIME
CITY OF ORONO CALLED IN C f �� �t�--
INSPECTION NOTICE SCHEDULED
PERMIT NO.��� � ��� COMPLETED
ADDRESS �2-g� ��'-�� ��-lC�
OWNER TELEPHONE NO.Cot2 5�1�1 ��
CONTRACTOR
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�; DESCRIPTION S �' �� ���F'.�
tL ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
y ❑ 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
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOU TION/REMOVAL
J ❑ DEMO-SITE ❑ SEPTIC INSTALL
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Q OWNERICONTRACTOR TO MEET YOU:_YES_NO
y COMMENTS: w`�� r'''`�'�'� 5 �55
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� ❑WORKSATISFACTORY:PROCEED L�PROJECTCOMPLEfE
� ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑pHOTO TAKEN
INSPECTOR WILL REfURN
O STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CAL�TO ARRANGE ACCESS.
Call forthe next inspection 2a hours in advance. (952� 249-46��
OwnerlContractor on site:
Inspector.fi��''''�i
White Copyllnspector's File Canary CopylSite Notice