HomeMy WebLinkAbout2016-01187 - water meter CITY OF ORONO * z 0 1 6 - 0 1 1 8�
' � 2750 KELLEY PARKWAY DATE ISSUED: 09/26/2016
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 763 BRIDGEWATER DR
PIN : 33-118-23-12-0091
LEGAL DESC : STONEBAY SEVENTH ADDITION
: LOT 4 BLOCK 1
PERMIT TYPE : WATER METER-RESIDENTIAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER METER-RESIDENT[AL
NOTE: INSEPCTIONS ARE DONE BY PUBLIC W02KS DEPARTMENT.
TO SET-UP AN INSPECTION,PLEASE CALL:(952)249-4613
5/8"NEPTUNE WATER METER
SERIAL NUMBER 68506714
ERT HIGH#1540102062
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)
(651)786-4007 CHECK 33719 324.67
Minnesota State License#:plbg-PC644177,mech-MB005379
OWNER
Wooddale Builders
6117 BLUE CIRCLE DRIVE
MINNETONKA, MN 55343-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicabie 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 compicd with whether or not specified herein.This pennit will
expire and become n�ll 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 L80 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 r due cause.
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A lica Permitee Signature Date Issued By Sig a re Date
FOR CTTY USE ONLY
�(�A rQ City of Orono
<y P.O.Box 66 Date Received_ Permit#
2750 Kelley Parkway
Crystal Bay,MN 55323 Approved By:(If Required):
(952)249-4600
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�� CITY OF ORONO-WATER METER FORM
�
���5 H'a�
���„�_. (Note:Some permits may require approval by the Building Official and/or Public Works Department)
GENERAL INFORMATION
I. WATER METERS must be picked up and paid for at City Hall.
2. If nossible,faY in this application ahead of time;we will then call you and let you know we have
the water meter in stock. Faa�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: —' � `� -� �.�C� ���/�
Owner: � � Mailing Address: �/y�t� ��+.���.��,•_�o
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City: / / �" Zip: '����
Home Phone: �`����-����/� Alternate Phone:
Contractor Information:
y� �
Contractor: ��./.��.-�'y.��t'��-. Contact Person: �
Address: ��< `���-z��� -�,�-, ,
� State License#: �/�G��y'
City: i��.Qe�,�..i� Zip.�`�--�i5�Expiration Date: ����v�J�>
Phone: i��'��"7�-?�� Alternate Phone:
WATER MCTER PERMIT FEES
WILL BE CAtJLL1LATED 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 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:
slzE: ❑ s�s°° ❑ 3i4�° ❑ ��� ❑otne� „
5/8 x 3/4
SERIAL#: 6$506714
ERT HIGH#: III !I I� I�I I� I I II�I I I III II (if applicable) ���i��115401io��2�obi��
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 ardinances of the City and the regulations of the State
of Minnesota, and certifies that all statements made on this application are,true and correct.
/
Applicant� Date: � o�� �� �
Original: 1-Address File
Make Copies For: 1- Utility Billing Department
. , �
DATE TIME
CITY OF ORONO CALLED IN � S�
INSPECTION Nf�TICE �� SCHEDULED
PERMIT NO.��-� COMPLETED
ADDRESS r ' �
OWNER TELEPHONE N0.7��`��- 3��1'
CONTRACTOR � �
� DESCRIPTION �� �� -�` �'�Q�`/
4i ❑ 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
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
_
J ❑ DEMO-SITE ❑ SEPTIC INSTALL
Z OWNERICONTRACTOR TO MEET Y�OU:_YES_NO
c�.� COMMENTS:
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W ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLEfE ��/ \
� ❑CORRECT VYORK d PROCEED O ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT NfORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOMERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pH0T0 TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call tor the next inspection 24 hours in advance. (g52) 249-46��
OwnerlContra or n site:
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Inspector. �-
White CopY napector'a File Canary CopylSit�NWice
„ � Main Office
5145 211th St W • Farmington, MN 55024
MN P I P E P�651)463-6090 • F(651)463-4554
& E Q U I P M E N T Rochester sranch
2913 County Rd 16 SW • Rochester, MN 55902
P(507)285-5389 • F(507)285-5392
N St. Cloud Branch
3028 37th Ave SE • St. Cloud, MN 56304
www.minnesotapipe.COCII P(320)258-3010 • F(320)258-3013
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