HomeMy WebLinkAbout2014-00947 - water softner _� CITY OF ORONO * z 0 1 4 - 0 0 9 4 7 *
� 2750 KELLEY PARKWAY DATE ISSUED: 08/25/2014 -
ORONO, MN 55356-
(952 249-4600 FAX: (952 249-4616
ADDRESS : 3265 SIXTH AVE N
PIN : 29-118-23-44-0002
LEGAL DESC : UNPLATTED 29 118 23
: LOT 000 BLOCK 000
PERMIT TYPE : PLUMBING(<$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER SOFTNER
APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00
CROIX CRYSTAL STATE SURCHARGE PLBG(<$500) 5.00
3440 YOERG DR MAIL-IN FEE 2.00
HUDSON, WI 54016- TOTAL 22.00
Payment(s)
CHECK 12783 22.00
OWNER
WICHMAN,MICHAEL&AVA
3265 SIXTH AVE N
LONG LAKE,MN 55356-
AGREEME1vT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances goveming this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
.
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Applicant Permitee Signature Date Issued By Si ture Date
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FOR CITY USE ONLY
; " - City of Orono
1%�¢O._:
�\'�� P.O.Box 66 Date Received: Pecmit#
+l� • �``�� 2750 Kelley Parkway
�� n`.'�- }.� Crystsl Bay,MN 55323 Approved By: Amount$:
``� i�� Y ��" (952)249-4600—Main
�',!�4ex� (952)249-4616—Fax
CITY OF ORONO—PLUMBING PERNIIT
(All Commercial Permits Must be Approved by the State Prior to City Approval)
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GENERAL INFORMATTON
1. You may apply for plumbing permits by mail or in person at the City offices. Applications will be
reviewed and a pennit will be issued within two working days.
2. Permit cards will be sent by retum mail after a review is completed. PERMITS ARE NOT
VALID UNTIL,YOU RECEIVE A PIItMIT. WORK MiJST NOT BEGIN UNTIL THE
PERMiT CARD L5 POSTED ON TI�JOB SITE.
3. Plumbing peimits may be issued ONLY to licensed plumbing contractors and to properiy owners
residing in the dwelling.
4. When any new construction or remodeling is involved,a separate building pecmit must be
obtained.
5. All work must be done in accordance with State Code requirements.
6. All work must be inspected and air tested before it is covered. Call(952)249-4600.
(24�8 hour notice required)
TYPE OF PERMIT
Check All That A 1
�Residential ❑Commercial(Appmval Required)
❑New ❑Additional ❑Repairs ❑Replace
❑ In Accessory Structure7
*You will need arior anaroval and may need CLTI'. (Per Orono City Code,Chapter 78,Article I�
7ob Site/Owner Information:
Site Address: �� ��Ll,l'l
Owne�1 C�,� �l C�1�Y�C�Ln n 'ling Address: ��J C ��• �
City: �Y��(l� Zip: 5�:��
Home Phone: '1� « — l 1-�"' /��� Alternate Phone:
Contractor Information:
Contractor: C �Q I S I� Contact Person: �'1 �( 1 d�J�f
Address���� I r� Sta.te Bond#: ���� � ��
City: ZipJ`[0��xpiration Date:
Phone: �S� —��! D � U�� ( Alternate Phone:
❑ Insurance—Cunent:
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PLUM�ING FIXTURES BEING INSTALLED '
FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 2 OTI�R
TYPE FL FL TYPE FL FL
Water Closet Floor Drains
Lavatory Sewer Ejector
Bathtub Laundry Tray
Shower Washer
Kitchen Sink Water Heater
Disposal Water Softener X
/ `
Dishwasher Wet Bar
Sillcocks Miscellaneous
:P�RNIIT FEE CALGULATION(S)
BA SED OFF-2�2 STATE STATUE
❑ Yes,this section applies
The replacement of only one Residential fixture or appliance that meets all three of the following
requirements:
1. Does not require mod�f;oation to electrical or gas service.
2. Has a total cost of$500.00 or less;excluding the cost of the fi�cture or appliance: and
3. Is improved,installed or replaced by the homeowner or licensed plumbing contractor.
Skip next section,if this applies; Cost of Pennit $ 15.00
State Surcharge $ 5.00
Mail-In Fee(If Applicable) $ 0
Total Permit Fee $��
(Permit Fees Continned On Neat Page)
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PERNtIT FE CALCULATION S -JOBS OVER$500.00
If above dces not apply;follow guidelines below:
1. CONTRACT PRI�E *is 1.25%of contract price with a(Minimum Fee of$50.00)
x.0125$
(contract price) (minimum$50.00)
2. STATE SURCHARGE
x.0005 $
(aontract priae)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
4. TOTAL PERNIIT F1EE(Add Lines 1-3 Above) $
■ * C4NTRACT PRICE or J B CQST means the acraal or estimated dollar amount charged for the
permitted work including m terials,labor,profit,and other fixed costs. It is the amount to 6e charged
to the customer for the wor done. If any material,equipment,labor or installations are fumished by
the owner,tenant or any oth r party,the reasonable market value of such items must be added to the
estimated cost or contract 'ce for permit fee purposes. In the event that there is a dispute on the
amount of the job cost, the ity may request the submission of a signed copy of the actual contract.
PLUMBING PERMIT APPLICATION AGREEMENT
T'he undersigned hereby applies 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 State of
Minnesota, and certif'ies that all statements made on this application are complete, true and
correct.
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A licant s Si ature: �y��J' Date:
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