HomeMy WebLinkAbout2005-P09064 - water softner PERMIT
CITI�F ORONO Permit Number:
2750 Kelley Parkway- PO Box 66 P09064
Crystal Bay, Minnesota 55323 Permit Type: Fixtures
(952) 249-4600 Date Issued: 8/10/2005
SITE ADDRESS: 2118 Shadywood Rd unit#
Wayzata,MN 55391
P��� 17-117-23-42-0016
DESCRIPTION:
Proposed Use: Residential
Permit Class: Plumbing
Pernut Type:
Fixtures Pemvt Sub-type(s): Water Soflner
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 15.00 Valuation: $ 0.00
State Surcharge Fee: $ 0.50
Misc.Fee: $ 1.50
TOTAL FEE: $ 17.00
APPLICANT: Culligan Soft Water Service Co. OWNER: Paul Hanssen
6030 Culligan Way 2118 Shadywood Rd
Minnetonka,MN 55345 Wayzata,MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICANT PERMITEE SIGNATURE S UED BY SIGNATURE
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
x� ,
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CYT'Y OF OTtONO APPLICATION FOR PLUMBI�YG PEIL'1�IIT
Bo� 66 (2750 Kelley Parkway)
Crystal Bay, IVTiv 55323
rENEYtAT,,LYFORMAT'YO
I, You may apply for plumbing permiu by mail or in person at she Ciry offices.
2, Permit cards will be sent by return mail after a review is completed. P�R1ti1ITS ARE NOT VALm iJNTIL
YOU RECEIVE A pERtiIIT. VJ012K MUST NOT$EGIN T3�ITIL T F_PERMIT CARD 1S pOSTED ON
TH�F. TOB STTP-
3. Plumbing permiu may be issued ONLY to licensed plumbing conuactors and to properry owners residino
in the dwelling.
4. When aay new construction or remodeling is��nvolved, a separa�e building permit mus[be abtained.
5. All work must be done in accordance Wirh[he: State Code requiremen[s.
6. A.il work must be inspected and air tested t�efore it is covered. Call (9S2) 7A9-4600. 24-haur no[ice
required.
Instriutinns Complete all items on this application. Compute rhe permit fee. Sign and date the
certification. INCOi�IPLET� APPLICATTC�NS WILL NOT BE PROC�SSED. If you have
questions, call (952) 249-4600.
Please check one: New _ Addidon Repair �2eplace
� Residential Commercial
J'�BSITE: 11�� ��ct�� �.� �P� � ��G I
Owner's Name:_p�:�, I ��.�5���,r� Teiephone Number• ���c�j,- � I - ��U��
Mailing Address: ��v�� � ,_ City: Zip:
Contractor's Namc: <<_�,_�� ; �� �-� Telephane Number: ( ��.- 3 --7�.��
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Mailing Address: ��> �> >�� ���City:��K1�, Zip: < r- �.
PL�iYIBING FIYTURE SCH1:nUI.E
FIXTUR� BSMT 1ST 2ND OTHI=R �'T.'YTURE BS�IT 1ST 2ND OTfIER
-rypg FL FL TY�� FL PL
'9Vater CloseT Fioor Drains
Lavato Sewer �iector
Bathtub Laur.drv Tra
Shower VVasher "
fCitchen Sin1c Water Heacer .
Dis osal Water Softener �
Dishwasher Wet Bar
Sillcocks Misc (Iist)
PERMIT F�E CALCUZATION(S) �
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20 2 State Statute Q Yes, This Sec�tion Applies
The replacement of a �tesidential f xture or appliance that meets alI thr�e of the following
requirements:
1) Does not require modificacion 1.o electrical or bas service.
2) Has a cotal cost af$500.00 or less; exciudina the cost of the fxtuxe or appliance:
and
3) Is improved, installed or replaced by the homeowner or licenced contractor.
Skip next seccion; Cost of Perinit $ r5.00
State Surcharge $ .SO
Mail Tn Fee $ 1.50
�f above does not apply, follow guidelines belaw:
l. C�ntract Price* is .0125 � of job with a 11�Iinimum Fee oF ($35.00)
x .0125 $
(cantr;tct price) (minimum$35.00)
2. State �urcharge. ** Add the State Building Code Division a (IVlinimum Fee of $ .50)
x .0005 $ �
(cono•act price) (minimum� .�0)
3. Posta�e and Handlin� (Only mail-in applicarions) $ 1.50
4. TOTAY. PERI�IIT F�L (Add lines 1-3 above) $
* CONTF.ACT PRICE or JOB COST means thf: actual or es�ima�ed dollar amouni charged for the permitted
work includiq,materials, labor,profii,and odier tixed costs. It is rhe amoun�to he chazged to the cusiomer
for the wosk done. If any material, equipmer�t, labor, or installation are furnished by the owner, tenant or
any other parry th� reasonable market value of such items must be added to ttie essimated cost or contract
price for p�rmit fee purposes. In the avent thac there is a dispate on che amount of the jab cost, the Ciry may
reques[the submission of a signed copy of thr acnial contracc.
** The STATE SURCHARG�is .0005 of the coiitract price under S1,OOQ,000 ar S.50 - whichever is greater.
For vaIuaiions ovcr�1,000,000 call the Department of Enspection Services for the price. .
Th� undersigned hereby applies to the City f��r issuance of a Plumbing Peimit, agrees to do all
work in strict accordance with the ordinanc�:s of the City and ihe regulatians of the State of
Minnesota, and certifies that all statements made on this application are complete, true aud
correct. .�
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A licant's SiQnature: - �� � Date: �"�,.�" � �
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