HomeMy WebLinkAbout2004-P08171 - vacuum breaker � PERMIT
C I T� O F O RO N O Permit Number:
2750 elley Parkway- PO Box 66 Poai�i
Crystal Bay, Minnesota 55323 Pe�mit Type: Vacuum Breaker
(952) 249-4600 Date Issued: 11/9/2004
SITE ADDRESS: 2100 Sugarwoods Dr
Long Lake,MN 55356
PID: 34-118-23-21-0020
DESCRIPTION:
Proposed Use: xesicienriai
Permit Class: Plumbing
Permit Type: Vacuum Breaker Permit Sub-type(s): Vacuum Breaker
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
Pressure vacuum breaker PVB Sprinkler System
FEE SUMMARY: PernutFee: $ 15.00 Valuation• $ 0.00
State Surcharge Fee: $ 0.50
Misc.Fee: $ 1.50
TOTAL FEE: $ 17.00
APPLICANT: Roto Rooter Services Co. OWNER: Chris&Carrie Case
14530 27th Ave.N. 2100 Sugarwoods Dr
Minneapolis,MN 55447 Long Lake,MN 55356
THE UNDERSIGNED HEREBY REQUESf S 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 SUED BY SIGNATURE
Conies: 1-File(SiQnitures Required), 1-Annlicant 1-Monthlv Reuorts, 1-Assessine, 1-Finance Page 1
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CITY OF ORONO APPLICATION FOR PLUMBING PERMIT
Box 66 (2750 Kelley Parkway)
Crystal Bay, MN 55323
GENERAL 1NFORMATION
1. You may apply for plumbing permits by mail or in person at the City offices.
2. Permit cards will be sent by retum mail after a review is completed. PERMITS ARE NOT VALID UNTIL
YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS POSTED ON
THE JOB SITE.
3. Plumbing permits may be issued ONLY to licensed plumbing conuactors 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 the State Code requirements.
6. All work must be inspected and air tested before it is covered. Call (952) 249-46�. 24-hour notice
required.
Instructions Complete all items on this application. Compute the pernut fee. Sign and date the
certification. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have
questions, call (952) 249-4600.
Please check one: New � Addition Repair Replace
�Residential Commercial
JOB SITE: a I C�� S i�c,c.,.r' l��O ct �t`�v�. _Zip: . S 3 5 Co
Owner's Name• C'1�r�S C�S e Telephone Number: 15 a- 4�t 5�C�4 S
Mailing Address: Y� U� S+���r^ �c��� b�' City: p�u�� Zip:�5 S �S �
C o n t r a c t o r's Name: R u-E-�- �v�� P�' Telephone Number:`7(0 3 -S t g. 3 �c��
Mailing Address: I�5�3 O at'1�`^ (�v� V�2__—City:��uv_�-ZiP�_�S 4�/ b
PLUMBING FIXTURE SCHEDULE
gIX'I'URE BSMT 1ST 2ND OTHER FIXTURE BSMT 1ST 2ND OTHER
Typg FL FL TYPE FL FL
Water Closet Floor Drains
Lavato Sewer E'ector
Bathtub Laun Tra
Shower Washer
Kitchen Sink Water Heater
Dis sal Water Softener
Dishwasher Wet Baz
Sillcocks Misc(list) � �"^�'�'e��
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