HomeMy WebLinkAbout2017-01656 - water softener �
� CITY OF ORONO
2750 KELLEY PARKWAY * 2 0 1 7 - 0 1 6 5 6 *
DATE ISSUED: 12/26/2017
ORONO,MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS : 4185 SIXTH AVE N
PIN : 31-118-23-11-0004
LEGAL DESC : LTNPLATTED 31 118 23
: LOT 000 BLOCK 000
PERMIT TYPE : PLUMBING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER SOFTENER
NOTE: WATERSOFTENER
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 52.25
OWNER
RICHARDS,T'HOMAS
4185 SIXTH AVE N
LONG LAKE,MN 55356-
AGREEMENT AND SWORN STATEMENT
The work for which this pertnit 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 dces
not gant 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 Signature Date
�2/26/2017 11:33 FA% 9529335049 CULLIGAN �NTRA f�002
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P.O. Box 66 ,Qate.Received: � = = .:: .. :�..,.. ..... < . ,
2750 Ketley Parkway :.:: �_:':.::: ..:� : � ::: ,. , . .,•.� •r '
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CITY OF ORONO– PLUMBtNG PERMIT
(All Commercial Permits Must be Approved by the State Prior to City Approval}
http:Ilwww.d{i.mn.Qov/CCLDlPDFIpe plumbp[anrevaaa.pdf
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1. You may apply for plumbing permits by mail or in person at the City offices. Applications wilk be
reviewed and a permit will be issued within two working days.
2. . Permit cards will be sent by return mail after a review is completed. PERMITS ARE NOT VALID
UNT1L YOU RECEIVE A PERMIT. WORK MLJST NOT BEGIN UNT1L THE PERMIT CARD IS
POSTED ON THE JOB S{TE.
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 invokved, a separate building permi�must be obtained.
5. All work must be done in accordance with State Code requirementS.
6. AI!work must be inspected and air tested before it is covered. Cali (952) 249-4600.
{24-48 hour notice requlred)
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�Residential ❑ Commercial (Approval Reauired) [BackflowDevice:�AVB ❑PVB]
�New ❑Additiona! � ❑ Repairs ❑ Replace
❑ In Accessory Structure?
*You wtlf need prior auprovat and may need CUP. (Per Orono City Code, Chapter 78,Article I�
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Site Address: 4 1�s Cour� 4 Kcx �
Owner�or� � Q����ar� Maifing Address:
City: Zip: �
Home Phone: Altemate Phone: 6) a � �1 � ��� �f
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Contractor: .u�ut�arv �rv,�r�R r,r��urzE,-tn��itact Person:
6031� CULLIGAf� WAY
Address: , MINNETONKA, Mn� ��aati State Bond #:
css�� Qa�•���o
City: Zip: Expiration Date:
Phone: Altemate Phone:
❑ Insurance--Current:
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„�'/2B/2017 11:33 FAX 9529335049 CULLIGAN MNTRA I�003
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FIXTURE BSMT 1sr 2ND OTHER FIXTURE BSMT 1s-r 2ND OTHER
7YPE Floor Ffoor TYPE Floor Floor
Water Closet Floor Drair�s
Lavatory Sewer E}ector
Bathtub Laundry Tray
Shower Washer
Kitchen Sink Water Weater
Disposal Water Softener �,
Dishwasher Wet Bar
Silicocks Miscellaneous
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1:• EONTRACT�PRICE '` is 'E.25% of contract price with a (Minimum�Fee of$50:OOj �- � � �� � �
o�C70• v� x.0125 $
(contract price) • (minimum $50.00)
2. STATE SURCHARGE
x .0005 $
(con'tract price)
3. POSTAGE� HANDLING (Onfy on Mail-In Applications) $ 2.00 �
4. TOTAl. PERMIT FEE (Add Lines 1-3 Above) $ .Sa. o�s
* CONTRACT PRICE or JOB COST means the actual or estimated dolEar amount charged for the
perrnitted work including materiais, labor, profit, and other fxed costs. It is the amount to be charged to
the customer fvr the w,ork done. If any material, equipment, labor or installations are fumished by the
owner, fenant or any other party, the reasonable market value oi such it�ms must be added to fhe
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 applies to the City for issuance of a Plumbing Permit, agrees to do a!I work in
strict accordance with the ordinances of the City and the .regu(ations of the State of Minnesota, and
certifies fhat a!1 statements made on this application are complete, true and correct.
� � Date: ��- a� 1
Applicant s Signature:
Building Officia(/ Inspector: Date:
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