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Home My WebLink About2016-01560 - water meter _ - � CITY OF ORONO * Z 0 1 6 - 0 1 5 6 0 * 2750 KELLEY PARKWAY DATE ISSUED: 12/22/2016 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 758 BRIDGEWATER DR PIN : 33-118-23-11-0133 LEGAL DESC : STONEBAY FOURTH ADDITION : LOT 16 BLOCK 1 PERMIT TYPE : WATER METER-RESIDENTIAL PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WATER METER-RESIDENT[AL NOTE: INSEPCTIONS ARE DONE BY PUBLIC WORKS DEPARTMENT. TO SET-UP AN INSPECTION,PLEASE CALL:(952)249-4613 SER[AL#68506707 ERT# 1540102118 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) (65I)786-4007 CHECK 33795 324.67 Minnesota State License#: plbg-PC644177,mech-MB005379 OWNER RICHARD HAUSTEN& MARY LYNCH 4986 S LAKESHORE DR 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 I 80 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. 4 � ��- 12= ZZ /� i�'\� c�� _i 1 ;_ ' r , . � �'� �' < �l �. Applic nt Permitee Signature Date [ssued By Signature Date ,r FOR C(TY USE ONLY City of Orono -��'._. � �� P.O.Box 66 Date Received��l��fPermit# � C-`�(�� - �7 (�- �, � 2750 Kelley Parhway Crystal Bay,MN 55323 Approved By:(If Required): (952)249-4600 �� ` . `qk.F1No�``� CITY OF ORONO—WATER METER FORM �- (tiote:Some permits may require approval by the Building Of�ficial and/or Public Works Department) GENERAL INFORMATION I. 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. Far Number:(952)249-4616. Also,you can call ahead of time to make sure we received the fax,or to warn us that the faY 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 �f Residential(May Require Approval) ❑ Commercial(Approval Required) (�New Meter ❑ Additional Meter—For: ❑ Replacement Meter Job Site/Qwner Information: Site Address: �J~� Owner:/ _� Mailing Address: Co��7 �,C L��C /.� -� City: i�/�ti1 , � Zip: �3� Home Phone: �oZ--3S�'-b�3 Alternate Phone: �2-f�"j- -�� Contractor Information: Contractor: .��f��(.CC�e /.�� ontact Person: � Address: /5�� State License#: p �7��T/ City: ��2c.�.c-- Zip�� Expiration Date: � ✓��e�J71 Phone: �3�G�y�d7 Alternate Phone: �i7�y�7`�d�J � WATER METER PERMIT FEES � WII.�L BE CAULULATED��Y�CITY STA�'�' �� ,� 5/8"METER- ❑ 3/4"METER- ❑ 1"METER- �, 5/8"HORN - ❑ 3/4"HORN - ❑ 1"HORN - ❑ "WATER METER (THESE WILL HAVE TO BE SPECIAL OKDERED&PRICES DETERMINED) l. METER FEE: $ � � � ' � 5 � �Z �� 2. HORN FEE $ � ;' l(� 3. TOTAL PERMIT FEE(Add Lines 1-2 Above) $ � �- � CITY-USE ONLY * For Current Pricing Refer to Current Year- Water Meter Pricing Chart * BRAND: "n�-', � �,> -� l L I lL s/s x s/a r 68506707 SIZE: ' �5/8" ❑3/4" ❑ 1" ❑Other IIIIIIIIIl�� IIIIIIIIIIIIIIIIIiII IIIIIIIIIIIII SERIAL#: — --�� #,�,_, '�� ERT HIGH#: (if applicable) III II IIIII I IIII I1IIIII I III III isaoio2i�8 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 ordinances 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: /a/aa �� Original: 1-Address File Make Copies For: 1- Utiliry Billing Department DATE TIME � CtTY OF ORONO CALLED IN INSPECTION NO IC�- � Cj�� SCHEDULED � � PERMIT NO. �''`�` � COMPLETED ADDRESS r�� C�U�-�C��. �?Y', OWNER TELEPHONE NO��`�'��5`}� CONTRACTOR � � z � DESCRIPTION � '�. _��`'�— W ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL � ❑ 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 _ � ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 OWNENCONTMCTOR TO MEET YOU:_YES_NO y COMMENTS: �� W _�__�>�( � I�� c� z cc � � —�, � � ^�(�( 1v��5� � � � � 0 � � Q � z W � W � � J W ❑WORKSATISFACTORY:PROCEED O PROJECTCOMPLEfE � ❑CORRECT VYORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY W 0 �(�RRECT WORK,CALL FOFi REINSPECTION TEMPORARY V BEFORE CONERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN INSPECTOR NRLL RETURN O CITATION ISSUED O STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (952) 249-46�� OwnerlContra or q�s e: , Inspector: '`� ''� � VYhite Copyl�nsPector's FNe C�nary CopylSfte Notke TIME� CITY OF ORONO cnLLEo IN ' INBPECTION N C SCHEDULEO PERMR NO. "�5 PLETED- ADDRESS � p�WNER T NE NO. �a 'a 20 $D� CONTRACTOR �d 4�`' DESCRIPTION � j ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING �O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION � ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑WATER HOOK-UP ❑ FOLLOW-UP W ❑AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATIOWREMOVAL _ r ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 01NN�OKTRACI'OR TO YEET YOU:_Y68_NO � S/ !S � COMMENT'� �� OG�-l�Gt� �° - d,0!�7 �1 /' � 0 � ° �{-� l� W OC �y F+ W W � � W ❑WiOfiKSATISFACTORY:PROCEED ❑PROJECT COMPLETE � ❑OpqRECT VNORK d�PROCEED ❑ISSUE CERTIFICATE OF OOCUPANCY W OO ❑CORRECT WORlC,CALL FOR REINSPECTION TEMPOFiARY V BEFORE COWERIN� PERMANENT ❑CpRqECTUNSAFECONDITIONWITHIN H��• ❑pHpTOTAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDEii POSTED.CALL INSPECTOR ❑INSPECTION REOUIRED.CALL TO ARRANGE ACCESS. Caq tor the next Mspection 24 hours in advanoe. (952) 249-4600 OwnerlCa�tractor on site: �nspector: Mmite CaPYMs�Ctor's FlN C�ruiry CoVY181N�loNcs