HomeMy WebLinkAbout1991-003721 - plumbing PERMIT
CITY OF ORONO PERMIT TYPE: F`LL�t�E:IhdG
1335 Brown Rd. South • P.O. Box 66 Permit Number: ���?=�;7'.�i
Crystal Bay, Minnesota 55323 � �" Date Issued: �3������'�f
(612) 473-7357
SITE ADDRESS:
�,;:�r��. °_;t 1i�N�,Wtii tl� aR
t.:�;U
�`. I . �`J. � :���.-1 f�c—:�L:—�:�—i�i};.��
DESCRIPTION:
��di�l14!`.�It!'� ���1'}14J.?. j ;+}-'t• �' i,`r,l�ir���-.:��
F'Iurr�c�i���� �,1�yi��:: �'v�=� iry;E`=�iv�iii{:=;�
� �Yi��FI `.L�_�:�•�� ;? �._�Ett�j!-1 f i_f�i'p� __ E�tY�H��.���
; ��,u►�+���; s �-::�z��:_,������v _.�rS�a:: � o r�_:����:_,a�
1 E�I:=�HW�1_�M�F� `_ ��I�_�._�:�:fj�.�t�:::�; = FL�=t+�s�; G�;r�Ihd:�.
I LA�?I��D;�1' i f-#A`'t 1 ���i'i:��i�::�i 1 �,�i�TE�i �-iE�+TE�
1 t�7i i i"E�i :�;t t�TI`�I�n' i '=�;�;!`;�' �'=�i°iF' 1 tJATE�i C:U�i:��El":(�i I
2 �aV�,T�:�i;Y/�i I 1 '=�:-ij;}�,���=�r';�I = ?_?t�#D�F II�l�D
�����,�� �r,a�'��, ���.:��,��,���"; �N; ";� �
� titi,,� ,� � :� �� t;
.�� �. � �� r � w p A �''�>�;
�4 ;w���� � H � �. +��
� � �� � � a, , �,�
0 � � z��� � �� �a�� ��, ��e�
�� �� w �� �� r� .
�.fl��k �l �i v Vp -�qil &.,� F a � w �v� {+�
�. '� �_�,� ..�mti°- � �,�.��,�'� .,�a^�'��J �n x�z,-,r��X,=
REMARKS:
FEE SUMMARY:
�:��� ��c ��_��. t r�} �a�� �r� ___-------��.��t�
� :surci-�at���e ______ __��.��} T,-�+.�,i F�� �1�.l .ta�i
:�uat���t.dl �1;'� .�i:;
CONTRACTOR: -- �����1 i���-�t� -- OWNER:
TH�:Ti''I�"=;���iv �'��{� ��_�:;:������1 �;���E'r;:_ C=���`3T�t 1i:T i+�liv
i 5�:��:�f t�I����E Tt��4df�:�i I NC3~;�_�T �;G =��iS �l�E.:=:T��i �VE :�
t1I�f�VET���N��::� 1'�3`d ��:_�.� :�T . Lt tt�I:=� F`��:t�:: t1N
i F.f�'� '�=�'r--�i 1 .7
" � fr- f .:r�r-� -. :. f_r - �••,•.. ,-,�-.,i .r_r.,_: s r r.,r�_;� _ _ _n �_ . . . _. r.•--r: , . ,�.., r. _
� "r`3C !f�Ji��-_.�j:_.�t�i�.E��3 f!L?"1r��'}' rii_'.�l%i:•- . � �'r -,:i_ '.� :�1 E i!� I�_f �"4t-li'�.C; }:-�t� F'!�t-t�... !!!f'"�fA�_��L-_i'i�-_�� ;.:—
.��f`%'.t..•.l t" �i�_l1 t-ii"i~� 1-iL!;3_';`�� �i_I 5.,,�i� :-j�»? f#.�I�f �i�. 1 1`; _� i i'•.1�_ f i_��I`�1 �i_.I:�is'�{:c� 'v!�Ti"1 !-ii__�._ i_3.�tq S��_.
. r��.:• -�• -•r•r r: - T - — :� , . _ r�� � s r T ' ..'!'v�' C:r:.: f r� .. h3'f"�".
�_��"i�.�i+�i_.� i_If'SiJ� i`vi—}i�t_•S".-: htf�!.% _. �3r{ !E.: l!T" !'!�!�?! .�__.t_� i!-i E".t}:.i.l�J.f'�{'f t•I_�L}F' FiFM'�.*.`C f P P`:t:!'i�.»14 €�� .
L
� �/ �
APPLICANT�PERMITEE SIGNATURE ISSUED BY:SIGNATURE (_��'
� C�TY OF ORCNO �PPLIC�TION FOR PLUMBING �ERMIT
Box 66 (1335 So Brown Rd) �., � �
Crystal Bay, MN 55323 . ,s� "�
*****************************�r**��****************************************
General Instractions j� !°"V"�'"°"�--
� 1. You may apply for plumbinq permits by mail or in person at the City f� 'ces.
2. Mailed in applications are subject to the postage and handling � shown belaw.
Perr.iit cards will be sent by return mail the same da1 the application s received. ��
3. Permits are not valid until yon receive a permit card.
4. Work must not begin unless the permit card is available on the job site.
5. Plumbing permits may be issued to Iicensed contractors only.
6. when any new construction oz remodeling is involved, a separate buil��,s}� perm�it 7��t,
be obtained. �i`� '�'
_ . _- ... 7. All work must be done in accordance with State Code requirements.
8. AI1 work must be inspected before it is covered. Call 473-7357.
24 honr notice reqnired.
*****************************************�********************************
JOB SITE ADDRESS: ��1 � 'ri C ���!V"
-.-. Occupancy Type: _� Resid ntial Commercial
OWNER'S NAME-.-��.i-�.�,-�°,�-, �� Qk���c� >.r�-i c.r._ Phone No. :
Mailing Addres s:��=;,'�� ,�?��-�,r A.�e r �.� City:�.t �_r. �•�_,�%c�a-��_
COidiic.a-,CTOR'S '.�.TAP''.E: � �- •�:..- -� 1, " `,� - :>. Bus. No. : "�J--�� 1� ,
, 4��,�
Cit iM�r„-.�iv,�k�aa ZiF: '�,`.�.
� � � Mailing Address: ���.L�-1+1 � "�'r,�l���-t ��,� g � Y=
Master Plumber's State License No. : �� � 1�.� City Cert. No. : J
***************************************************************************
- PLIIMBING FIXTIIRE SCHEDIILE
� (Show number of fixtures of each tyFe on each floor)
_ FIXTURE TYPE BSMT 1ST FLOQR 2ND FLOOR OTHER FIXTURE TYPE BSMT 1ST FLOOR 2ND FLOOR OTHER
--------—�--- -------—+----- T---- ------ ------------- --------- ----�— —---
S:ater Closet_� � I __ % r � Sewer Ejector j �
___________ 1____� s�__l___� ____I______ _____________�____ ___ _____ _________ _____
Lavator � �~ � � � Laundry Tray i
y ---�-� --�-- --�---�------ ------------- ---- ---•----- ---------�-----
--------- � �
- � '
Bathtub i j � �� Washer � �
' ------------- -----------------�---- ------ --------------�---- ---r--- ---------r-----
Shower I � ! I --_-__ Water Heater , �- �_ i
,... : ( � ' ------ ------------- --•----- --------�-----
-------------�-----�--•------- ---- i
� , +
-. - _.: Ritchen Sink ' ' i Water Softner�__-I , i
---------'-----, --i----�--------------- ----------- � � 1��'.�=rc�l�_r -----'------
---- � - --�
i �
IIisposal , _-___ Wet Bar l I
-------------1---- -�--- ------- - ------------- ---- ---.--- �-----�-----
---
� ;
Dishwasher ` ' Sump Pump 1
� -
-------------1-----�----•--- I--------- ------ ------------- ��- -�---�p ---------- -----
Sillcocks----� �-�---•---1--------- ------ Misc--(List�- ---- -- , _
1 m�4_ a.1J=�F,,\
Floor_Drains-1-�---1--- �---�--------- ------ -------------1-'--l1�tY-�c�,�2¢,���"�_-----�-----
- ie�tYe�t***x�tx�tz*�cie�tie�exi�i::'sx**ttt�**:k*ir*i�***�k�k***�k�t*******�t**�F*�F****,t,t****it*�ir*�F*
l. Fizture Fee The minimum Fermit fee is $30.00 $^1(d�.�'�
Compute number of fixtures � x $5/fixture
x $3/fixture reset..,�?�
._^,...;,_
- 2. State Surcharge $ .50 ,
3. Postage & Handling (Only mail-in applications) $ 1.50
. 4. TOTAL PERMIT FEE (add lines 1-3 above) $ �✓ �/ ��''� �
***************************************************************************
The undersigned hereby applies to the City of Orono 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 certifies that all statements made on this � ''
,
application are complete, true and correct. � i
' i
�. . i
. . ... � ���^ r'' Date: ��`�`7�! I` `i
Signature of Applicant�I ,r�C-La y� �- � 'y�'��1 f
::; _
DATE IME
CITY OF ORONO CALLED IN ]�' ' I .
INSPECTION NOTI SCHEDULED IL2� � CEn'1
PERMIT NO. COMPLETED _.( ` �_
ADDRESS
OWNER CONTR.� nrn,[�p.-� I�
TELEPHONE NO. :���� 7� 17
� DESCRIPTION
� 01 FOOTING 11 MECHANICALRI �6WELLTESTPUMP ,
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADINGIFILLING
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 19 LAKESHOREMIETLANDS
Z 04 WALL BD. 12 WATER HOOK-UP �__ 34 TREE REMOVAL
Q 05 FINAL 13 METER S�f/FURN ON 17 SITE INSPECTION
� 07 DEMO-SITE 14 SEWER HOOK-UP O6 PROGRESS
v 07 DEMO-FINAL 27 SEPTIC MAINT. 21 COMPLAINT
i�UM�INQ Rl 15 SEPTIC INSTALL 22 FOLLOW-UP
v 10 PLUMBING FINAL 23 SEPTIC FINAL , �
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
y COMMENTS:
�
�
�
0
a
�
0
�
W
�
Q
�
W
�
W
�
�
� RK SATISFACTORY:PROCEED ❑PROJECT COMPLETE
W CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CAIL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
e:
Inspector: �
wnia copynnspector. Canary Copy/Sita NoNos
DATE TIME
CITY OF ORONO CALLED IN � ' I D-9�
INSPECTION NOTICE SCHEDULED �! % �
PERMIT NO.^� 7 02� COMPLETED �� _�_
ADDRESS � �iC-
OWNER CONTR. `�v
TELEPHONE NO. �3� ` ����
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 16 WELLTEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAV/GRADfNGIFILIING
O03 INSULATION 24125'WOOD BURNER/FIREPLACE 19 LAKESHORFJWETLANDS
Z 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q 05 FINAI 13 METER SET/TURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
� 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
J 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
y COMMENTS:
�
a
j
0
�
�
0
�
W
�
Q
�
2
W
�
W
�
�
d RK SATISFACTOHI�PROCEED O PROJECT COMPLETE
W •
� CORRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
W
O O CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECO'VERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP OROER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Cali tor tl�e next inspection 24 hours in advance.473-7357
OwnerlCon e:
Inspector: �
Whlts CopyAnspector's � Canary CopylSits Nollce
(� DATE TI�
CITY OF ORONO "�'CALLED IN � ' � M�
INSPECTION NOTIC SCHEDULED � � � 3�a-�
PERMIT NO. � COMPLETED � ll
ADDRESS C5 CU'W �
OWNER �'P.�n� � ��ae�I�CONTR. �norx-(J S o n � �q
J
TELEPHONE NO. � 3 3- 7 7 I 7
`
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 16 WELLTEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAV/GRADING/FILLING
y 031NSULATION 24J25 WOOD BURNER/FIREPLACE 19 LAKESHOREIWEfLANDS
Z 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q 05 FINAL 13 METER SET/TURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP 06 PROGRESS
v 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
= N RI 15 SEPTIC INSTALL 22 FOLLOW-UP
v 10 PLUMBING FINAL 23 SEPTIC FINAL
� TO MEET YOU:_YES_NO
v�, COMMENTS:
�
4
j
O
a
�
0
�
W
�
Q
�
W
�
W
�
�
d
W VYORKSATISFACTORY:PROCEED ❑PROJECTCOMPLETE
� CORRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
W
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOYERING PERMANENT
O CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALI INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cail for the next inspectan 24 hours in advance.473-7357
Owner/Contra on e:
Inspector:
White CopyAnspsctor's F k Canary CopyISIM Notfc�
��IIT
CITY OF ORON� PERMIT TYPE: �����;_i� Wa�'EF�
1335 Brown Rd. South • P.O. �3ox 66 Permit Number: i}`;��i���-
Crystal Bay, Minnesota 55323 Date Issued: i��1�=����i
(612) 473-7357
SITE ADDRESS:
��=i�;�. �_�tJ�;A;.;��i���;I� ��:
L'�',J
F'. I . �`�I. � �::tl.-i i��t-'.�:�t-:,::'3-t��z 1'�
DESCRIPTION:
�����t)" �� ��ai•�_)� ��i"if�.i i• i�t'��� :��L.w���' %t �t�!I���;
,,,_,:_
_�CU7C)' ttt �,+�_t .F'';' 3d1���1' . ? ;+�'=' ����� ��".i'�?;C
� ,� � y�
����v�%l� ,y � �.' "a �;,� � ��'Hu"s4,yx,�l� �'�n F' .
� �
r�"-_9:�wy� y,�v � �yu� y t/ � �,ir�'��!����` � �� �
t�4w ��"�a^p��F�, ''.� i4 m � , �?'��� �'��� .�,�
Y �. u � ' . '+� p'
� $ � "���y'��'�' pr�'��r � �� J �,�� �
h � � �,i �'� �� �
$ .i o�r � �,� ���"' �*��r� '�� t�"
��� �� ��. � � ,�� d "���.�1
,s � ; C� � � �� l'��"�1 k � � m t ��'���..
�r '� �� ��`��' � �� � ��"p'1�.�� �. �' dr
� 4 ti �mw ^� ya�� !� � �m � '
k9X� �� µ i,<
�' Y` Ml .�"FF�� � �y �a'� . .
�..�� 3�� � i„� . +�+ y�hl ,.
� �, ���� ��� � � ��� �.i �a��y�.- ,
� § '
�r�, ti ��� ��r���r� �a"��" rs C �4 ��t
:da rre(w m! lu , .,�� '�va p,._. ' �ui ��-
REMARKS:
FEE SUMMARY:
' ��t{SC FCr' �aiF�l a, I�t}
�f)
' `-�l,il`C�'fcll'''yt� _____....__ _�.'�._:�
T���t.�l F*+� �t=.,::� . �;i�
M Qi� .�►r� L ,.S�
(a Z, 0 0
� CONTRACTOR: -- ���F�� I����f� -- OWNER:
Tt-ii11�1F'=3��rt�l PL.E,G ���:i:}'����1 �E���F.°� C:i����;T�;t1t�:TI�ii�!
� �.�i�ir1 t�flh•ihJE'TC��t-::�t IiVCjt1:�:T FiD :�:��'� WEE:L.TEF� r�VE L;
M I�Ii�lETiit�i��::� hil� ��=��15 :�;T . Lt_t!7 I�_; �'AF;f:: t�N
� i:h.��i _=i_.:�,-.771 i
"' ,,._;;. c.�<<,z�,vr- r, i4:"'t�C—'�1F C:t'"._4. . _,"k'o�' F:'T'„'!':'Y'S:_ ' '• .. 7�i'•.i.'_ _ '•r'{:f s�.r;�r„_t.r_,,,'"_k,'_=`.
i�-i� 'i{�{._iC'.€l W�3.}0:}l4�.:.l.s ;�r p�r_�-,I r:r���;$i�.�_� ! •_ 4'".._!':I t!•� _�.f.i_�E� } {_i !•Ft-:i'•.i ��-t� f�=_t�4L_ �.'�#"!'l�_�'�C�}�!:(i ._
,_�i-,r=t�I3~ I[��1 t-�f�l's.: �!:�;-�._.F�::; i i a i.�'t�i i f-1#__� '?,�`•_�t'•�i+. 1 fZ� ���il l�_ ! �_�_�;ii �L..L F=l�t�i�.:� �J.t i�i: HL_L_ t_� #��{ t E`f"
-�•�,:;.�+:••- rr,- - tn' r -• --�-;� - �. .�* .• r�,T � � r��r;:-.t �s- : •
#_i��S_i}�.�i_I I_[n_).L t`�?(-tf�i.�".�_. P-i�+ai: -.!4-4 1�, �_�i` t'f i�yit�i-,`.,,s_f �;•-`! L":�ti�,�i,!Z l��i-i iL.i_i�ic� !l�_�a,�_�1!'�:C_1'iC.?�t •_� .
---'��" ' i
APPLICANT/PERMITEE SIGNATURE ISSUE BY:SIGNATURE
, . ��? �,
CITY OF ORONn ,,,, APPLICATION FOR UTILITY PERMITS
Box 66 ( 1335 Brown Road So ) SEWER WATER WELL
Crystal Bay, MN 55323
*********************�****************************************************
General Znstructions
1. You may apply for utility permits by mail or in person at the City offices.
2. Mailed in applicationsare subject to the postage and handlingfees shown below. Permit cards will
be sent by return mail the same day the application is received.
3. Permits are not valid until you receive a permit card.
4. Work must not begin unless the permit card is available on the job site.
5. Utility connection permits may be issued to licensed contzactors only.
6. Contact the City offices for utility stub as-built locations. DO NOTEXCAVATE IN ANY STREETAND DO
NOT TAP ANY MAIN without express approval of the Public Works Department. Issuance of a permit
does not grant this approval.
7. All work must be done in accordance with State Code requirements.
B. All work must be inspected before it is covered. Call 473-7357.
�c�c***ic**�t�t�k*�k�t**�t�t�t�k*�t�rir*�t**�t�c*****ir******ic**icic�lcic*ic�t�t****�c****�k**�t***�ic�t*�k�t
JOB SITE ADDRESS � � � ��,�
�/__C) i ��r. CGi✓i.�)�-ru �
Occupancy Type : �_ Res"' dential Commercial
OWNER'S NAME �,n�,�.,i,�� �'p,.��� x�'�� d� Telephone No.
Mailing Address ;���,� �,,���._,;,,r, A J�cY.-.
CONTRACTOR'S NAM��Mp:�,�� ��., ��;��. (1cr�_ Business No. �j�. ��r'���
Mailing Address l�c�� � M-1-1��. Z,���.t �-�-�;�� .a. �� u �53y�
Naster Plumber ' s State License No. M��1�'� City Cert. No. ����_
**************************************************************************
PERMIT TYPE AND FEE CALCULATION
MUNICIPAL SEWER CONNECTION ( $30 per stub) $ �Lx�
pipe size inches; material PVC (on sand fill ) ;
cast iron
SAC Charge ( $425 . 00 ) must accompany all sewer permit applications unless
prepaid. If not prepaid, a sewer connection permit will not be issued.
MUNICIPAL WATER CONNECTION ( $30 per stub) $ �� �Lj
pipe size inches; material copper
other
�
W�TER METERS must be picked up and paid for at City Hall. �,�;�
�(5/8'? meters = $95. 00 3/4" meters = $130 . 00 )
_�
PRIVATE WELL INSTALLATIONS ( $30 per job) $
check: new well replacement well
repair existing well
casing size : inches
REQUIRED minimum setbacks from drainfield & septic tanks = 75 '
CALL FOR A SITE I.00ATION BEFORE DRILLING
Upon completion, City must be sent a copy of state well record.
**************************************************************************
1 . Subtotal of above permit requested $ � ��� �,,��
2 . State Surcharge $ . 50
The State Building Code Division Surcharge of $. 50 per permit must be included for
each well , sewer and water connection permit requested.
3 . Postage and Handling (Only mail-in applications ) $ 1 . 50
4 . TOTAL PERMIT FEE (Add lines 1-3 above ) $ /,�'7� ��
**************************************************************************
The undersigned hereby applies to the City of Orono for issuance of a UTILITY
PERMIT, agrees to do all work in strict accordance with the ordinances of the City
and the regulations of the State of Minnesota, and certifies that all statements
made on this application are complete, true and correct.
�, c
Signature of Applicant 1J�C,G��cti pr; �► Date : �`�-�`-�-�°) �
DAT^ n TIME
CITY OF ORONO CALLED IN r
tNSPECTION NOTICE � SCHEDULED ' � V
PERMIT NO. � r/� COMPLETED v �
ADDRESS � � �
OWNER CONTR.
TELEPHONE NO. 93 3 — �� l�
� DESCRIPTION •��� G�-'�-�� .... .
� 01 FOOTING 11 MECHANICALRI 16 WELLT TPU
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAV/GRADINGIFILLING
4j 03 INSULATION ��24125��WOOD BURNER/FIREPLACE 19 LAKESHORFJWETLANDS
Z 04 WALL BD. Yv1Z WATER HOOK-UP 34 TREE REMOVAL
Q 05 FINAL 13 METER SETITURN ON 17 SITE INSPECTION
� W DEMO-SITE 14 ER HOOK-UP 06 PROGRESS
v 07 DEMO-FINAL 27 SEPTIC MAINT. 21 COMPLAINT
= 09 PLUMBING RI 15 SEPTIC INSTALL 22 FOLLOW-UP
v 10 PLUMBING FINAL 23 SEPTIC FINAL
Z OWNERICONTRACTOR TO MEET YOU:_YES_NO
y COMMENTS:
o�
�
o �' � 0--3��
�.
�
0
�
W
�
Q
�
z
W
ti
aC
�
� �LWORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
W �O CORRECT WORK 8 PROCEEO ❑ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECf VYORK CALL FOR REINSPECTION TEMPORARY
V BEFORE CdVERING PERMANENT
❑CORRECT UNSAFE CONDITION WRHIN HOURS• ❑pH0T0 TAKEN
INSPECTOR WlLL RETURN ❑CITATION ISSUED
O STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Caq fcr the r�xt inspectbn 24 taurs in advance.473-7357
or site:
Inspector:
�Nldb CopyAnsp�ctors Flk Canary Cap�rISN�Nodce
F �IZMIT
CITY OF ORONO . '"'- PERMIT TYPE: ������;�;I�,��
1335 Brown Rd. South • P.O. Box 66 PermitNumber: �:��Z=17'�4
Crystal Bay, Minnesota 55323 • Date Issued: t�SI:=�1/_=�f
(612) 473-7357
SITE ADDRESS:
•�_�t��. :_,t 1i�Ah}�1f��ai� Q�
�:=:V
F'. I .td. � :�:�.-11�=;—:�:;—:��—f)t)i_i
DESCRIPTION:
r,_..__ ti-.. n�- r.�; r-
�.ati�t:,i i;.=� r-r���ii 3. �. , Y��� �'!-�� E-Fi �•sE:�:.�
r " � ri� ���,--
t= I l,liYt�'�1 i i°:a 4y��i'{�:: �Y T�� .,,._���Ur��a'•_�_
�E'�•C)' ti.�i s':t'.' C'�,`-
C'1��c t' :=�Y�'i.�3 ���t�ii�t�r�L�' ::�.;_,=:_i 1 #'�i_i=;
h' i� ' �i s'i
Fiefi►���t•e �+��i�'r'�' iu��n<<:�r�' =�'.,��_E���i:�v.��
r•��t.��� rY,w.;� �_;�r,�°�,,!_,
� �✓r� �,�r���"� �" �`'
�g. R'"�'�v�,��� ��'dY�rr �b���'�i��v ,�1�4�r�� '
� " � ��*9 ���a� �p*�d�""� k�) %,n
� ���kt��� �"s ��� „��'�",
h �y � �$ 4
F/ A
� {� '. M1bM� ryMfN j'"�� ���
§��,,�N�`Mh M � 'k�7M��*a5 ;s.�N' ���d^ ��.W�"'� ��i.;"�,.
� 's4� �M1i�s�i
��,� - v� � �� ltiaka`� `"k,+.
' �
REMARKS:
FEE SUMMARY:
� E:ase ��� _ �'�����?�?
� �'��t•�l �ec -------�,��. if�_�
CONTRACTOR: -- �F���� ���»t• `- OWNER:
THtiMF'`��t�tN �'L��C; �`_'-�:�;:���:�:�1 R�C�ER:_: �:���r,��.=:-�.'�tl�:TIi=tP�l
i;;.�C}1 ��I I PlIVETt�td��;A I t�1Gt 1=_T RG :;;��; 3�iEE;:=,TE�: AVE ';
t�ii`�fi�lET��:=1`J}�::►"-► I'��! r,5��t�� :_:`�' . L��tt)I��� F'�'r�i��: h'�td
���1::1 °�:;::--7 i 17
�t-;C �i:JLlG_f1�_�.�CJ�4C L7 f'!C s+;���'i' F?r��'�_S�'.�w� §�� ���"_ii!'?!����=���_#i�f . �_i 4��5��..i._ ��"'ee:_ C�'1t_f=iL_ �.i 1!"�Ti�..�`����'!t_�'� ! �—
�=�i�i�.!� ��' 1 i.=s_l ri�'�iJ �i�=.i;'-:�,_';.�'+_`•�: �i.l �€i -n#�_L iA�'.Jt;;��. �1'`� T��I�'.�L.� '_�_;�`E�'-'�.:i-1i���_t_ 4j T �'i� i-;y_; 1..�3�'�r 1ij'
-r:rt..:_: _ . .., t _ _ h,r� _ j � r,; �rir `-r;: — _ ' r:rh � — -.t �r��*'++,:rks--r•
i_ip�l�yc_� i_ij-�i i i;�(•=!{��L•�= h�t!'�€Lf �Tf=F!�� ...�i'" 1"�J.!d�4r.�.i_i! Y`: C::F i i i..13!��_i l•i_��..�G �'!�'-`t�,i-si_E��_i�� s ._ .
�/� / /�Ci[i^�L..C�'� V
APPUCANTiPERMITEE SIGNATURE ISSUED BY:SIGNATURE � „�/�I��
" PERMIT
���"Y �"i�' O F�O N O PERMIT TYPE: ���:�����:��
1335�rown Rd. South • P.O. Box 66 Permit Number: t y{};;��i
Crystal Bay, Minnesota 55323 Date Issued: i��,;�y�j,:�j
(612) 473-7357
SITE ADDRESS: �
"�I i71 =:t JGAi�iWf�lt;�l� C�Fti i
TLN
�'. I . PJ. ; �:.:�.-11:�;—��.:—i�.—�3i���a
DESCRIPTION:
1 �;E�►T I h�l� '=,Y�L,TEIy{'�� �'LIfE :�,I�� _ Fs iEL i�lATl1F�F�� %A:=:
I�{�r�::E �::�r�:�;�;��; �i��I��L ;�=�'�XA 1��:���
z ►�I f: �:i iNC�I T I��►N I I`JG ����-::� t:��i��fi.I E_� i i��iCjc% _;:=t�"E;:t�F.�a:;t�z�
?'�it•j°=; �
S VENT I LAT I t`.�t� �`iH�::� �—_:::;?���:t;�:E�f f Fl_tL.��� 4—E�ATH
i GA:=; L i PaE I N'1�'EC:i' �•iA��::E s:�,�;°: L_I C�� I i�'`�;�=°�r: .
,�` �� u���`���,�j� �� � � � ,�
' �k � P�"' �-�ir�k �,�,.; 1 � w��� "�'��
� .�`'" W r hY� �'�&�����j,� ."r � y"l ��.
w
' €��- — ��•�ry µw : �,p^�1��
�"��a 4 r ' � *� - �� �� �
r _
s "
���� .. r l��yn a "�� -.st�
a � Y s � � �F
�_ . r � ,��4'G�,��y�s�,:�,� y t N� ���� .
�. � �.,j. 3 �,�Mt�'g.� w
w"�,�'u '�- r � �� __
REMARKS:
FEE SUMMARY: '
E:a�C F eC $F.CI. t#i 1
_�u�-ct-�ar��� __ _��.�'�
?�s{.�1 Fc� __ _ �,t�ri .!�,ti
CONTRACTOR: -- q�,�,� ���,j��. __ OWNER:
[:t�t►��TRY:�i f�E HTG �e �'�1t�L i N�i ::�1.4t������+'�� F1EE�E�i:� i:t�rd',T�i�1��T I t�IV
f i��:t:�.(:� �:i�` fiC� :�t�f :=�4�;�, WEr�:���'�fi �'iVE
DEL�ii��i t11�� ��:,'.L:�_ °;;T L��t;I:� F`�iR��; i�1hf ;��.1�,
�F��.',�,f c`�.l�.F.—#;�:.�`=1 '_��`{_f—N�'=f'Sr;.
r-�-:;r - -� - r=-.F:r- ,
i t�� �F��i!.:��\`•=��:�����1� i`f�'l�i._;=��'� i';i'_Zs'#_4�`•_�i�:. �"'!:.�',il1'-� _ TI il`� :1 i 411-if•�.•'_= I�`iG f\i:.f-�1L ��'��'`I?t_i`r'C_�'i�i."_i`•��`•,� �
,: �
r, _,_,.. .:� „�;<<.., ,.. ,....r r-,- r:j-� - ti r,y: -
r' i r' `_ � -� ..# : — �t 7
� �. �� .• � - .
•�+�'�C.�..•--(' .�Y�L1 He+�i.? t-4t_i�tLE".•=• ��_� L:_ �-dL_i.. :b�f_�};r�. �k'� _+ ! �1�:: f �..•�_FI�lF—L..L FSI'15•�� '�� t�4 1-�i!i._ l.?1.,{ ���("
i!{�`I_Ij��!_I I.�i''.�A 1`•3�-�iV!_•�.�..�'� �tii,e t _, t f-�i�f_ F_�: i°���*a��i _�i 1�j-; %;1 J 3.L_v L E��it_3 +:��..li �;��R�'iRt��'Il���I �� .
��.
�� �-�
A LICANTiPERMITEE SIGNATURE SSUED BY:SIGNATURE
�t '�r'>Y r , r�a:- ,�- F't'^�"°" p"',' x t�i �, '��� "-� i�''�"�" ��?.3�;"�s
"� � .�. .. . j �{f-�� 7 �"�. e, s _ � ,"� .�. .Iaqgq'�F't.��.�. , _
� ��`� �� Yw3A: ��S.
� ' , � � . - .''�i�
i . � i
= 1 . . __ . .�_ ...._-. ' ' . ' -,.
S Y 4 ,. ��' �:
�� � � ,. � ' ���`�l
CITY OF ORONO
' APPLICATION FOR MECHANICAL PERMIT �
�`'- a�g�f�?�
;'.:la,
�f', G$[�j�AT. INFORMATION
�'� 1. You may apply for mechanical permits by mail or in person at the City
offices. Mailed-in permits are subject to the postage and handling fees
shown below.
2. Permit cards will be sent by return mail the same day the application is
received. PERMITS ARE NOT VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT
BEGIN UNTIL THE PERMIT CARD IS POSTED ON THE JOB SITE.
� ' 3 . When any new construction or remodeling is involved, a separate building
'� permit must be obtained.
'y 4 . All work must be done in accordance with State Building Code requirements.
�' 5 . Al I work must be ins ected (rou h-in and final). CaY 1 473-7357. 24-hour
, P 9
�"� notice required.
�` 6 . House Heating Test Record must be submitted before final.
��
�� INSTRIICTIONS Complete all items on this application. Compute the permit fee.
, �, Sign and date the certification. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED.
e„W=�:
If you have questions, �aii 473-7357.
�� WALK-IN PERMITS apply at City Offices, 1335 South Brown Road (Cty. Rd 146)
�...
� MAIL-IN PERMITS enclose fee - Mail to: P.O. Box 66, Crystal Bay, MN 55323
;�E *******************************************************************,t************
�..
�"�� Please check one: ^�New Addition Repair Replace
s��-i
�:1 �� �cc� ' ��`-
,� JOB SITE: ���1 SvJ � Zip:
Owner ' s Name: e6a-� C�r Telephone Number: yz�-E y4�:
Mailing Address >��5� v�l��-s�+�.�- �� � City: S� L� ' �',r�- Zip: .�y�-
Contractor ' s Name: �„�.��-+-rys��z �.<;J�<�; Telephone Number: y�tG /���]
Mailing Address �c%S�� C�R.�i- .2� City �.zl�+� Zip S�3i�
********************************************************************************
MINIMUM FEE ( $30. 00 per project)
********************************************************************************
��'' SYSTEM DESCRIPTION: $15. 00 each unit
��:��,
�t
Heating Systems :
�s�: Quantity. �
�: Make: ('�rn.L�
� Model: ��0 L6-
�' �S,cA
�; Fuel. a�-G.�
;�� Flue Size : 3" �f�
�� Input BTUs : �3��%
�
�t Output BTUs : ���Lcw
{� CFM. ;�IIm
'�ry'' ***************' ****************************************************************
��� Cooling Systems :
�a Quantity: I
��; Make: �arr�./ �
`�sa MOC�e� . ��5'�Ch:i>3U�
�°`� Ton s . S'
ra��;:
� H.Power:
�� ********************************************************************************
:Y
�i
�k..
p �n �^{. �.` j �. ,:� i �`-� �`` ; 14 4`* � �:� ^ya`r � �3+��.'7 �'���`�r�": v .¢*�.�"� "'?
� { , s. .� t � . ,r� ,d�. r�� "7�����,�.� 'r,t,k� � .�.: z*�� w hv'i4.�����.�M ke ��
� � � ��i� i'�' '�q w �fi r �' �^'�,� tq i `S'
'�i r� a ? a � `�` � �3� }w�'��k' '�' �`*' ..
� fi.�„ � ��{ t � � , '�` � �� �t7�¢ �.r F '��+$ �aR j���` "_ Y�;i� 3,�?'�v .
� ..,• "�� �.� , � �,� .1 .'$ .`e�'._B�' � ra � � f-'rs'i� � 1�`�,' t � �Q
x ,,.
r � �� t
° � � �a. � �"a���".� ��' �+ t,��*�� �_�p t��� c. . .,. ,. �.uky���:_ ., � _ 3'�e-. ,_ �,,a�
� :�' � �+ °�' +� ,,j a � � , � � � y� �
.� { ��,� �� ,�'`
x; ' � � r�' �'�'�� � ��� �"' �&�.,�`�`��k: y a-.
. ,
i
�e r t :� 1 aG �, >
..�-. � '� � ;� �' . � B . �-�.. st�,� �`� �s�.'�" �0
. -, ,� . ��, r
A�
�. . b ,_._ ..��`a � � .�r. .,. ..s._. u. �`L ��. .... .,. . .cl .a.Y, R .,.. .�]z v . _ ..,.a.r�..r. �.� - �t.n`�_
rlsi +'!ti' ` F } l w, .`�" .,,�,�„"'°�"1:.�n- :z�rr'— rclR��.�i _ � W
� :3�t1�n � i � - -
��i,��sr a"� �+ � �
#`.. S .�1 a^ �� � �.
a,����" � ..�; �s:�'�� . . : .. . . .. ` ' t;�
, r ��.
r
*WOOD BIIRNING EQUIPMENT $15. 00 each unit ��
Wood stove with f lue ,�,��
Wood combination or add-on unit �
Factory fireplace with flue ' '; ,,
Factor Fireplace (s) freestanding built-in
Wood Stove (s ) franklin, other
Brand Name Mode 1 No. �k �
Mfgr ' s Min. , Clearances, side , rear , min. flue dia.
Tota 1 �`::"
******************************************************************************** i�
VENTILATION $15. 00 each project ;;
:
�,
�a
No. I Kitchen Exhaust �_ ducted recirculating I�� cfm u = ;
No. _�_ Bath Exhaust (must be ducted outside) �,sT cfm
No. G Other Fans: Locations cfm
Total
********************************************************************************
FOEL STORAGE (must be approved by fire marshal ) ��
$15. 00 Permanent/Temporary �
Fuei oil, gallons underground inside outside .�,��� . ,;; �.��,`�'�
LP Gas, gallons �
Other Gas opening ;�
******************************************************************************** ��
GAS LINE INSPECTION �
High/Low Pressure $15. 00 �� �'
******************************************************************************** x:
PERMIT FEE CALCDLATION
1. Total of above Installations or Minimum .Fee (.$30._00) $
2 . State Surcharqe. Add the State Building Code Division , �
Surcharge to each permit $ . 50 ''
�
3. Postage and Handling on all mailed-in applications, $ 1. 50 � ��.� Y:
4. TOTAL PERMIT FEE add lines 1-3 above $ ` �"' '" ��
The undersigned hereby applies to the City of issuance of a Mechanical Permit, ;;;�
agrees to do all work in strict accordance with the ordinances of the City and
the regulations of the Minnesota State Building Code, and certifies that all �;1�;
statements made on this ap ication a omplete, true and correct. ri�
;,�
;�`":
" �;,
Applicant' s Signature: _ _ Date: • _ �� .� ;
. ��
x : 4:
^# A�
� �� H
i a -,
t {;
��$s���,x. f _r„ �� -� « '• z v' rr- t
�,!:: a a c�nc �- � _ r�{ , � r`' a ,�y�`' ��.� � r,
� .
".,
} � ��.
�'
{Yf�E'��-Y 1 .:�. ', ' ��: _ �. �,�. .' 1" �y� ��5
�� d ,. � . 3"':
,j� ��l y�� '� . . _
m ,�¢F '�,l-?��.�+'tf5 Y• c$ �, - . � -
� �r � ' '«a'#, `� x:
� � �• �'t ':�',
"�y�. � �', I � j _ - � . _.. . .:�
`}y' �T ' h x' . _ - . . �.
� �
, K,
. . �, . .. .....
..
� r
�� �
._ � �
'��. : . x .�. . ...�-� '- ,��' -�:.� .
� r:ed : .���. 4 � i.. .�:N. '
� � .,, .. . .. . , i...
. r. . . . . �. �..
. �. � �.. _ ,..
.
t : ��: . ..� -� . ,- . ��'
' .
i.:.
:
.
+ �! � .�. . .. .
w:
�t . � . ,:. . . . . . . ', . ..
f j �'`
� �d s
r
. .- '
�...: �, . � .... .. .. r s
? 1
� �V y�._ - � -{z . F
� _ � y�. � \ �� ;.J . . .. e+R,"
t �
a3'� _ �` � � '� y, .
�1a'��''�Y ..(- F'f
.
. . .
i i � .
� », .
� .-.
/. . " t..... . `• �.� . �.: . -. . . _1.
� . + -
r�4y 'fs � _ .. . . '. -
�_a_e_ . .r.t.. xY .3...n .,.,.,. a�3z�.._t ...�.�tt`v."_.. ._ ....�. . . �ilm.����._. a�yuo....�.�a_ad s� ,-� ..�3TS6#a.ui�--�` ..e_, ss- 1
1
ATE � TIME
CITY OF ORONO CALLED IN �1/.���C�
INSPECTION NOTICE SCHEDULED
PERMIT N0. � COMPLETED ��_
ADDRESS ���A.�j`7�c'�
OWNER �-� CONTR. �'Y' S
TELEPHONE NO. ��� � 1 a��
� DESCRIPTION
� 01 FOOTING MECHANICAL RI � 16 WELLTEST PUMP
Q 02 FRAMING 18 EXCAVIGRADING/FILLING
y 03 INSULATION 2M25'WOOD BURNER/FIREPLACE 19 LAKESHORENVETLANDS
Z 04 WALL BD. 12 WATER HOOK-UP 34 TREE REMOVAL
Q 05 FINAL 13 METER SET/TURN ON 17 SITE INSPECTION
� 07 DEMO-SITE 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO-FINAL 27 SEPTIC MAINT. 21 COMPLAINT
= 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
J 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
y COMMENTS:
�
a ' u, J
� '
a
�
�
0
�
W
�
Q
�
2
W
�
W
�
�
d 0 RK SATISFACTORIf:PROCEED ❑ PROJECT COMPLETE
W
� CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
W
O ORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑INSPECTIONREQUIRED.GILLTOARRANGEACCESS.
Ca11 for the next inspection 24 hours in advance.473-7357
ownedc�,t e:
Inspector: �
White CopyAnspectors Is Canary Copy/SiM Notice
PERMIT
CITY OF ORONO ,� - � . PERMIT TYPE: ���:H��,���.�y�
1335 Brown Rd. South • P.O. Box 66 Permit Number: - �,�:��
i.?i:?:=
Crystal Bay, Minnesota 55323 Date Issued: E��.,;�j�f'��
(612) 473-7357
SITE ADDRESS:
�1 t�1 ��,t;UA�;W�►tip G�:
�'3V
F'. I . ��i . :f��.—i 1�r�—'�_;—�:1—i�i;3��
DESCRIPTION:
:; F I REF'Lfii.:E � � �,��`d � �
�r � � ro ��� � ;i ,, �;
� � � �� �� �
� ' � '�� �„� � ��r u��:>
4� r �, �
�'�� w ,��
,� ,z . � ��; '
� "��• m� � � �, � ��
� � � + � ,� ��^� �� ,�,� �. `�
tii,a,��w� ,� s M r
�� � �' p
�
. r • � rc�*' '� -� fi r�h u�`':
P � '�`�ae . �' .v ,
� � �k�" �4 yi �"r��� � �`�
�� � �u � � '� o �
g� A 5 �F*� ✓+���� J�f�M� 3 i '�u�d�� �� ,da. 's
���p,�`� v���°a d r �1� �'N� ,� o l �
�, ��'��a°� �� � ('��'�"� Y r,t'�� `�t�`��` +
� � i r i� y� v���; � � � �»N�' �
ry �A'�.���t ����'i �;.a �M . � v ,
'� "�� ��n,,u3 '" . Jw
^� '� t Y 'l w �� 3r
' v. ����' ��" : �"� � �4p u
°�r�.� � ���� �N,���� �Pd� yn y un ,�fia� ; � .
�,"`�� � � a �"��°� , � :� r i'� � j f I !� t i!-Yii
�± ,.'
..
��'°y,��� ; �`` �"�"��e��.�'�d�'.�+�' �' �,�.,�i � � 6�i V L� t
-.: ,, . . _.._,� w.�„ .
L'r etn�!� �C�CT/�C
1 11TR 4L 1 1 jLL 1
�f ltjf�!{NZ� y
REMARKS: �;� ��1� ;�.G'4
�c��.....�ls�r►r� �
�ttt.v v�
��; r•-
i ue,�.i�� .�.r'iv
GHE�;�' TL 3�.5�
FEE SUMMARY: j( liLt:t1�'r-!1l��, ,�:uj
�l i.l'lsj��} 41.%1.�1 iiV�1 �i'�3�i"�!
{:Giji/Ji�i
��ctY+C ��� `�+�.;, f_lt„i
:�iLi T`C�'lLti''�� ----------�'-��'{}
T�+t-�1 F�� �4!�,•�tl
CONTRACTOR: OWNER:
-- FiF�F�I i c��ifi. --
i�1Ei'�i�=��'��L I T�ti�l F I FiEf`LAC:E I i�tC: :_°�:1'�-�::;7t i 1'Hc I:_� u�=tt 1G�A:�
- =,�:�:�;�' _:� �'i yr�, �:[:i�TT =:T
yt,�. _. . . ::• .�- �,.� ��:;7�=�
�,�,:;7�a ;=H�tr�,�=►1=�E
-•��-:F;•�Jt���,r" f��� - r. -
+S'1i-!,'•. i i=. ( ��,i '._.:;:{.`�r�_�-._i ;.t j<<
-- _— �d.�. ~ - � - -
, , � �._�.
: , .r f ��,_��: ,�_�___�—��.__—__
:,r _
��-�„i_
Tt7 .,f; = f,�- c-.:--; T .",;����.�wi ,_taT°��
€� r�r-t a` �' �.. V :� 't����"!t'�!�- _�i I i{t� {t_`s j`li•.1�.,� i 1�7r= i.!�.;-1,.,_ 11'!:'�i . - '
f t `�'�• a'il,.l"3��:�''t� e.i� .�`_�i�..- -, _ . .. �e -F�-.r• { �(—� • - ' `(''i: 3_tj=•
��� i)tt��Ji���.'.�.�1�.��� ... ... ` • : i: Ej�^ li; i �i._i.. �..•T F �
•t� ,�:� • T";,; ;F;1'i�:: C � :`s-`i.s.�€?,:�,,�- i r•i
•r'r r��,r_, i�_i i }-i4�4L? tr-i.t-i�C_i::� _!1.� �,!`_{ P-ie-L- `1't� �'1�' _._ "'�-.� _ � T ' - �` �i�}'j�rk ;�= .
-.r r . • _ t FiT r i 3.-. l_i_Ei��: 1",4:_iyt�_}�t"t.+.:t i_i��t • �
^ t: . 7 r�+r�.F•.:.- - ::ti i -;'y�;i�... {_�t'" i°i i!'�!:.._��[_I R�'i ,t���'i{.._�l�';'•.:t
�i;•;I_ �at ._ ,4;��i�'��,___... . .':a�..: .. .
\ �
AP I ANTiPERMITEE SIGNATURE , ISSUED BY:SIGNATURE ( _
� � � ; � ��� �� �� � �
� � - �� �' ±y;: �_
� �. � ` � �u' s�- �y`�
,,. �__ � . '- . . �._ � . w ` ' _ - t_ <
.� .! �'m
.�4 -�'"� " zd $ "�G*+�4 t
N `� �. �������r .-p ����� .
`� CITY Og ORONO ��` � � '
� ,a ; ` 'sc� � ��`� �,�� ��,�:
APPLICATION FOR MECHANICAL PERMIT , ; `�.; � :;,�.��h��:�� ;s��,,k�� ^��:
, GF.NFRAT. INFORM�TION �
�,.
1. You may apply for mechanical permits by mail or in person at the City
offices. Mailed-in permits are subject to the postage and handling fees
shown below.
- 2. Permit cards will be sent by return mail the same day the application is
received. PERMITS ARE NOT VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT
BEGIN UNTIL THE PERMIT CARD IS POSTED ON THE JOB SITE. -
- 3. When any new construction or remodeling is involved, a separate building
permit must be obtained.
4. All work must be done in accordance with State Building Code requirements. `
�k`' 5. AI1 work must be inspected (rough-in and final). CaYI 473-7357. 24-hour f
�;' notice required.
6. House Heating Test Record must be submitted before final. �
�
� INSTRIICTIONS Complete all items on this application. Compute the permit fee ;�
` �'� Sign and date the certification. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED �
� If you have questions, call 473-7357.
�
WALK-IN PERMITS apply at City Offices, 1335 South Brown Road (Cty. Rd 146)
��" MAIL-IN PERMITS enclose fee - Mail to: P.O. Box 66, Crystal Bay, MN 55323
********************************************************************************
Please check one: '`� New Addition Repair Replace
JOB SITE: O � SU c,� S Zip:
Owner' s Name: t Telephone Number: �--
Mailing Address : ' o City: t e.- Z�p:.�-5��7 5
��` Contractor' s Name: . � -��-- Tele hone Number:
Mailing Address S��S . City: Zip:
********************************************************************************
MINIMUM FEE ( $30.00 per project)
********************************************************************************
.:�: SYSTEM DESCRIPTION: $15. 00 each unit
Heating Systems: ��
- Quantity:
Make: --
Model:
Fuel:
Flue Size:
� Input BTUs:
Output BTUs:
CFM:
,R�.: ********************************************************************************
�;
_ Cooling Systems: `
�°
Quantity:
Make:
Model:
Tons:
*��� H.Power:
********************************************************************************
:�
-: = t�';�
° ��.
.,� �. ,`.� � >,s
r � ta � � a � �'�
I ' .�
� � �rr ^3
� � � � � � �r � � � �� �
� ; +r a �
�€� " � ,� T �, s � '
£� ? . .J`s�-- .a {.;
� -fS ��
l� ' � Y^� '�•L ;�4 X 4 � ~ z'�� �.
•: .. . � : - ' �k
� �• .. � � I "` � ��' � �� i. �" �� i ix ��-� ;(�s��� ��
��.. � $>��,�5�.
k
C �
e 1"` .. . ... . . . „ ,. , ...,5� ,_. _ _ . �s..3,.a.X ,_4 �..z__ ,w, . ._ C�P,.."..� ..z._...4_.t. �T,
. . . . e�?�' _ . � ���.�i�ss+7���r���a��P�iu���a�
€-�"�-� �, g,�:^��y r�r ,� rs�, -- '.ax� � � y��.z*-�� z,� �
# ,�'s8� a �� � r b a,,� '�-:_ •..z:3 . . �,L��
$ :+' t 33 q . � �b. Ra 'f� k � °'�..� t
"Mx'k'"x t' r�rt t#'� ; .�. .� � .. �'I � � 'c�`*d 4 � ..Y`�a* se
���'
4 } � t*� �� � � � � � y�� � k j,}'. � . � � t- t .
a�p `-y5'T� � � � '�; e,��SF' � �f,yP'�' .i� � � � � � V�
S 'l� Wl ,aw��' 't$, 'f$h�. - .. dF j �;i"�
4` � i �. 'SR�g�a31� k 'ffi, �� ��' x ,�_t { aa:.� .. . � . 3t�u,�'� t�.�p
� � P 1 a(.
„ x
."Y�"'� .�' <��� �',i
„�;� ��. S. ...p x.isR'. . . � .. . . �,� ... . `}{ .. ,. . �
s:
=� *WOOD BIIRNING EQIIIPMENT $15.00 each unit ''
��` Wood stove with flue '
Wood combination or add-on unit '
Factory fire�lace with flue ' ;
Factor FireFlace (s) freestanding � Masonry f;
Wood Stove (s ) franklin, other
BrandName Model No. `�
� Mfgr's Min. , Clearances, side , rear , min. flue dia.
Total
********************************************************************************
VENTILATION $15.00 each project
,�
�.
No. Ritchen Exhaust ducted recirculating cfm t� ' i, �..';� �;°.„ '•
No. Bath Exhaust (must be ducted outside) cfm - ;
No. Other Fans: Locations cfm `��
Total �'a
******************************************************************************** ��
FUEL STORAGE (must be approved by fire marshal) `�}
' $30. 00 Permanent/Temporary � �
Fuel oil, gallons underground inside outside �,, x� ,s '�y�
LP Gas, gallons � ��`
� �¢
Other Gas opening '�
********************************************************************************
GAS LINE INSPECTION `
High/Low Pressure $15.00 �
******************************************************************************** "�
P$RMIT FEE CALCIILATION �
1. Total of above Installations or IrSinimum Fee ($30.00) $ ,� v�
2 . State Surcharge. Add the State Building Code Division °- �; ��
Surcharge to each permit } '�" e' A
$ 1. 50 �` � ��x �
3. Postaqe and Handling on all mailed-in applications, ��� ��V
4. TOTAL PERMIT FEE add lines 1-3 above $ ��
�
�� The undersigned hereby applies to the City of issuance of a Mechanical Permit, �
agrees to do all work in strict accordance with the ordinances of the City and �
' the regulations of the Minnesota State Building Code, and certifies that all �
��
statements made on this ap ication are complete, true and correct. �
�
f y � 4, , �
Applicant' s Signature: C Date: �!/��� ^l� : ,� � ��
, �, f�
.,..'i ,s`' 'x �
::� ,�'' �`�j
.. .,, �*�
� . : }
� . � ' i: Y # . t ..� �'V � .
��� � �e� F3 ,.;g :�, ': . � 4 y M°
�.�^r � �., � j.,h� c E���' � �a
-}t �,f � �'': � ` ..a*n �'„y.
�.� ?Y ; . . .. _ �� �.�
.
v �
. h"� �„�� tw- , :� .. . - � � �
a ; k
s �� "�' 'rd'` �j :
���� � � iF ^�r`t ""�
� t "+-�� 2 ;, - � ` �"� � r+z;
,
a $ � t ' - ` r� � �� - w j
,� t�+»6`�" j �' c�.'��� �:: t f� F,.'2t"'
w c�`.�e�-"E"� + �, i: ,'� `� y � � t..
�ya ¢''`1.�, : g x'. . �"�, " ,��' s � i�
� ,
P��-'I'�. `� .. .i *.{t.,�. ' �V,� . . �3-
�, 4t X: <<:
� 6
��(�. S . }_: S ' 1 ��:
'HF ')`Y'�:R - � . , ��.
R5 .1 ! t'�� 4,� , C
Y S, �' t Q # ..1' - ' L'� •� �'�d
� �� � j � ��:� � �
h '°'y'rB' 'Y j 4 . .. �� t�
,�r��.��� 1 "r,�* � �c� , t �N'� '
�•��,^•� � �� � � � � .: �}* ���
�.��; �: �` - * `� �: '� r ;Y�
���� � �� ��:��� i a r, , � . �.�� t�i�
;`v
t ���g{h�b" . -k 2� M S.
t���^'^d �{� k �' _ �. .,
3� �¢``NT i��ry.� l - Y F � 9 �.+�� ���{�
�:
J��s r.;Yc:�Y�c'.s L�.'_ . .«.T:� ._,.Xr�»_.r� a ..w... _ _.. � . .. ..,a.. .. x.... . . . .. . 1.�n . � ._ . � .. .oY t.v.I.L.u� _-a..t�a.a�4
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE 3��j�SCHEDULED �`t—�t� '� •/�
PERMIT NO. � cOMPLETE �( `�(
ADDRESS O r S ��
OWNER CONTR.
TELEPHONE NO.
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 16 WELLTEST PUMP
Q 02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADINGIFILLING
y 03 INSULATION 24125 OD BURNER/FIREPLACE 19 LAKESHOREIWETLANDS
Z 04 WALL BD. TER HOOK-UP 34 TREE REMOVAL
Q 05 FINAL 13 METER SETITURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
i 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
v 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
�
a �
�
J
0
a
�
0
�
W
�
Q
�
2
W
�
W
�
�
� �YWORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � GTATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContr r site:
Inspector.
White Copyllnspector's File Canary CopylSite Notice
'Df ATE_.�. TIME
CITY OF ORONO CALLED IN .fQ � y�
INSPECTION NO C � SCHEDULED f.� —7 // i��
PERMIT NO. � 3 COMPLETED L� �f
ADDRESS ��U �/�'
OWNER CONTR. c� �7p
TELEPHONE NO. �� � — �� 76
� DESCRIPTION �
� 01 FOOTING 11 MECHANICAL RI 16 WELLTEST PUMP
02 FRAMING 11 MECHANICAL FINAL 18 EXCAVIGRADING/FILLING
Q03 INSULATION 2M25'WOOD BURNE IREPLAC 19 LAKESHORFJWETLANDS
Z 04 WALL BD. 12 WATER HOOK•UP 34 TREE REMOVAL
Q 05 FINAL 13 METER SET/TURN ON 17 SITE INSPECTION
� 07 DEMO—SITE 14 SEWER HOOK•UP 06 PROGRESS
� 07 DEMO—FINAL 27 SEPTIC MAINT. 21 COMPLAINT
? 09 PLUMBING RI 15 SEPTIC INSTALL. 22 FOLLOW-UP
J 10 PLUMBING FINAL 23 SEPTIC FINAL
� OWNER/CONTiiACTOR TO MEET YOU:_YES_NO
y COMMENTS:
W � S
a
�
�
O
a
�
O
�
W
�
Q
�
Z
W
�
W
�
�
� WORK SATISFACTORIP:PROCEED �PROJECT COMPLEfE
W CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
O INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Cali for the next inspection 24 hours in advance.47�73rJ7
OwnerlContra ite-
Inspector:
Whib CopyAn Flk Canary CopylSite Notics
CITY OF ORONO PERMIT NO.: 2011-00350
� t.- 2750 KELLEY PARKWAY
' '� ORONO,MN 55356- DATE ISSUED: OS/17/2011
' 952 249-4600 FAX: 952 249-4616
•ADDRESS : 2101 SUGARWOOD DR
PIN : 34-118-23-21-0019
LEGAL DESC : SUGAR WOODS
: LOT 005 BLOCK 003
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ROOFING-CEDAR
ACTIVITY : O/S BUILDING-LJNDEFINED
VALUATION : $ 36,000.00
�
;
APPLICANT pERMIT FEE SCHEDULE 531.25
A FRIEND OF THE FAMILY INC. STATE SURCHARGE(VALUATION) 18.00
11091 I OOTH AVENUE N.
MAPLE GROVE,MN 55369- MISC FEE 0.00
(763)493-3224 TOTAL 549.25
Minnesota State License#:20317090
OWNER
APPLE,RICHARD&CONNIE
2101 SUGARWOOD 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 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
tevoked at an ' e due cause.
... /�7 / `� / /
A plicant Permitee Signature Date Issu y S' ature ate
� ' SEPARATE PERMITS REQUIRED FOR WORK OTHE T N DESCRIBED AB .
i
City of 4rono
, `~ Building Permit Application for Internal Work
(windows, doors, siding, re-roof, etc.)
Mailing Address: Permit number:
O�,�,�.0 PO Box 66
Crystal Bay, MN 55323-0066 Date received:
a �' �` F Street Address: Received by:
"s',�, °��`�� �ti 2750 Kelley Parkway Plan review fee:
't<9x.ESx0�,4' Orono, MN 55356
Total Fee:
Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us
This application form must be completed in full and all required information must be submitted.
Incomplete applications will be returned. (Please print)
GENERAL INFORMATION:
Job Site Address: �.;� �c� I S;tic;,4;2��c�� � Q ,
Will this be a Parade of Homes, Remodel rs Showcase Home or other Display Home? ❑ Yes � No
If yes,a specral event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service will be
required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed.
CONTRACTOR/APPLICANT INFORMATION:
Name: A Fc�t,.� o-� �.c. �,..��� �.�.
State License# a d3� -� a 5 � Expiration Date: 3-3 i - a c;�
Lead Certification Number: Expiration Date:
(for work on homes thaf were consfructed prior to 1978
Phone: �, ,Z_y f c� :�y.�� (office) 7 E 3,31 j-3 y�U (cell)
Mailing Address: �i v� � ,a��. �„�. � City:�,��r Gny,� ZIP:.a• ,5-�36�
Contact Person: ���,� ��u�r Applicant is: Contractor / Homeowner (CircleOne)
Email and/or Fax: �4,,< <c3 Q-��.+��n�.�a•`
PROPERTY OWNER INFORMATION:
Name: IZ,,-� 4- C�=��;-�
��� �
Phone (day): ���• �7� - �Y7 �(
Address: a co i 5 w��,,�,�,,,> ar . City: L�,:S��,.,L ZIP: $�-�
Email and/or Fax
PROJECT INFORMATION:
Type of Project: Any earth movement may require
❑ Door(s) ❑ Remodel ❑Water Damage MCWD review&permits:
Minnehaha Creek Watershed District(MCWD)
❑Window(s) ❑ Repair � Storm Damage 18202 Minnetonka Blvd
❑ Siding ❑ Restoration ❑ Other: (specify) Deephaven, MN 55391
Phone: 952-471-0590
[�.Re-roof ❑ Fire Damage Fax: 952-471-0682
www.minnehahacreek.orq
Overall Project Description:
Estimated Construction Valuation of Project (excluding land) $ 3���v o`�---� C�. �
APPLICANT ACKNOWLEDGEMENT:
• Agrees to provide all information required or requested by the Building Department;
• Certifies that the information supplied is true and correct to the best of his/her knowledge. The applicant recognizes that they
are solely responsible for submitting a complete application being aware that upon failure to do so, the staff has no alternative
but to reject it until it is complete;
• Some or all of the information that you are asked to provide on this application is classified by State law as either private or
confidential. Private data is information which generally cannot be given to the public but can be given to the subject of the
data. Confidential data is information which generally cannot be given to either the public or the subject of the data. Our
purpose and intended use of this information is to annually update our records and records of other governmental agencies
re uired b law. If ou refuse to su I the information,the a lication ma not be issued.
Applicant's Signature: -�-- Date: S-/7-l/
Last Updated: 03-01-2011
DATE TIME v
CITY OF ORONO ca,�� �� p►-_ �
INSPECTION NOTICE SCHEDULED �'L o_//
PERMITNO�d`�'�o3� COMPLETED
ADDRESS ����'��
OWNER TELEPHONE NO.
CONTRACT, �'�� �t"GZ����-• �0�� " 9a` Zy�
>; DESCRIPTION �`�"�����""�'`� � �e�'`'��
� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WEfLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
v ❑ PLUMBING RI O SEPTIC FINAL ❑ FOUNOATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
��., COMMENTS:
�
W
a
� �' ��t,� �� � 1 �
0
�
0
�
W
�
Q
�
Z
W
�
W
�
�
1iY�W_ORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE
� ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
0 ❑CORRECT WORK,CALI FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WFLL RETURN
❑STOP OFiOER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Cail for the next inspection 24 hours in advance. (952) 249-4600
OwnerlContractor on site:
Inspector. < <
White Copyllnspector's File Canary CopylSite Notice
ATE TIME ✓
CITY OF ORONO c ��� �
INSPECTION NO ICE SCHEDULED
PERMIT NO � —Dd 3Sa COMPLETED N
ADDRESS a �D � � CQ,�W�d o�1 !�
OWNER TELEPHONE NO.�P`Z Z7 D Z�1,�
CONTRACTOR �►-_ - -- - lh�
>; DESCRIPTION �`"-""
� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
J � PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO �
y COMMENTS:
�
W
0.
�
J
O
�
�
O
�
W
� •
Q
�
Z
W
�
W
�
�
W �WORKSATISFACTORY:PROCEED �PROJECTCOMPLEfE
WjO CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O �CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFOREC�IERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTIOPt REQUIRED.CAL�TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (g52) 249-4600
OwnerlContracto
Inspector.
Whi Copyllnspector's File Canary CopylSite NoUce