HomeMy WebLinkAbout2017-01506 - water softner � � CITY OF ORONO
2750 KELLEY PARKWAY * z 0 1 7 - 0 1 5 0 6 *
DATE ISSUED: 1U15/2017
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2790 SILVER VIEW DR
PIN : 33-118-23-42-0002
LEGAL DESC : MEYER DAIRY ADDN
: LOT 001 BLOCK 001
PERMIT TYPE : PLUMBING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER SOFTENER
NOTE: WATER SOFTENER REPLACEMENT
VALUATION OF PLUMBING 500
APPLICANT PLUMBING FIXTURE FEE 50.00
STATE SURCHARGE PLBG(VALUATION) 0.25
CULLIGAN SOFT WATER SERVICE CO. MAIL-IN FEE 2.00
6030 CULLIGAN WAY
MINNETONKA,MN 55345- TOTAL 52.25
(952)912-7379 Payment(s)
CREDIT CARD 5107 5225
OWNER
MOHS,JIM&PAIGE
2790 SILVER VIEW DR
LONG LAKE,MN 55356-
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 [he
State Building Code. This permit is for only the work described and does
not grant pertnission 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 afrer 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.
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Applicant Permitee Signature Date Issued By ' ature Date
11/15/2017 11:44 FAX 9529335049 CULLIGAN MNTKA C�002
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��� City of Orono FOR C TY U N Y
� NO P.o. eox 66 Date.Receided ����
50 Kelle Parkwa
Crystal Bay, MN 55323 Permit# ��✓� �'� ` �
`;� �� (952)249-4600—Main Appr:oved By
��rFSH�0.E (952)249-461fi—Fax ' � ' � t.�� ' '
-Amount$ ' •
CITY OF ORONO- PLUMBING PERMIT
(AI! Commercial Permits Must be Approved by the State Prior to City Approval)
htt :l/www.dli.mn. ov/CCLD/PDFI e lumb lanreva . df
GENERAL=INFORMATION . ' > � ' `' ' ' ' '° - ',
1. You may apply far plumbing permits by mail or in person at the City offices. Applications will be
reviewed and a permit will be issued within two working days.
2. Perrr�it cards wiil be sent by return mail after a review is completed. PERMITS ARE NOT VALlD
UN7IL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL 7HE PERMIT CARD IS
POSTED OW THE JOB SITE.
3. Plumbing permits may be issued ONLY to licensed plumbing contractors and to property owners
residing in the dwelling.
4. When any new construction or remodeling is involved, a separate building permit must be obtained.
5. All work must be done in accordance with State Code requirements.
6. AI1 work must be inspected and air tested before it is covered. Call (952)249-460d.
(24-48 hour notice required)
;
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' � £ TYPE aF P,ERM(T(Check All That A I
� . ,:. PP Y). . . , ,�� ;
�Residential ❑ Commercial (Approvai Required) [Backflow Device: �AVB ❑1'VB]
/ �
� NeW ❑ Additionai ❑ Repairs Replace
❑ ln Accessory Structure?
*You will need rior a rovai and may need CUP. (Per Orono City Code, Chapter 78, Article f�
Job;Site 1 Owner`lnformation.';
Site Address: 1�U � ��� v 1�-`"� � �
Owner: �Q�Q 2 ���5 Maifing Address:
Ci#y: Zip:
Home Phone:7�3 � a3 - 0 l Alternate Phone:
Confractor lnfo'rmation:
Contractor: Contact Person:
. L
Address: ���Q �uL�IGAN WAY State Bond #:
i ,
C ity:
�`�'��� "���`7��� Zip: Expiration Date:
Phone: Alternate Phone:
❑ lnsurance- Current:
Page 1
11/15/2017 11:45 FAX 9529335049 CULLIGAN 3iNTRA f�003
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FIXTURE BSMT 1sr ZNp OTHER FITMPEE BSMT Floor Floor OTHER
NpE Floor Floor
Water C(oset Ffoor Drains
Lavatory Sewer Ejector
Bathtub Laundry Tray
Shower Washer
Kitchen Sink Water Heater �
Disposal Water Softener �
Dishwasher Wet Bar
Silicocks Miscellaneous
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1. CONTRACT PRICE *is 1.25°/a of contract price with a (Minimum Fee of$50.00)
.500 •0� x.0125 $ �� � a�
(contract price) (minimum$50.00)
2. STA7E SURCHARGE
x .0005 $ ' �
(contract price)
3. POSTAGE �HANDLiNG (Only on Maii-ln Applications) $ 2.00
4. 70TAL PERMIT FEE (Add Lines 1-3 Above} $ `5�� �` S
* CONTRACT PRICE or JOB COST means the actual or estimated do(lar amount charged for the
permitted work including materials, labor, profit, and other fixed costs. 1t is the amount to be charged to
the customer for.the work done. {f any rnaterial, equipment, iabor or installations are fumished by the
owner, tenant or any other party, the reasonable market value o� such items must be added to tF�e
estimated cost or contract price for permit fee purposes. In,the event that there is a dispute on the
amount of the job cost, the City may request the submission of a signed copy of the actual contract.
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The undersigned hereby appiies to the City for issuance of a Plumbing Permit, agrees to do all work in
strict accordance with the ordinances of the City and the regulations of the Stafe of Minnesota, and
certifies that al{ statements made on this application are complete,true and correct.
Applicant's Signature: Date: _ 1�- I -��
Building Officiai/Inspector: Date:
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