HomeMy WebLinkAbout2017-00995 - water softner r
CITY OF ORONO * Z 0 1 7 - PJ 0 9 9 5 *
2750 KELLEY PARKWAY DATE ISSUED: 08/2U2017
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2102 SUGARWOOD DR
PIN : 34-118-23-21-0021
LEGAL DESC : SUGAR WOODS
: LOT 002 BLOCK 004
PERMIT TYPE : PLUMBING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER SOFTENER
NOTE: WATER SOFTENER REPLACEMENT
VALUATION OF PLUMBING 2849
APPLICANT PLUMBING FIXTURE FEE 50.00
STATE SURCHARGE PLBG(VALUATION) 1.42
CULLIGAN SOFT WATER SERVICE CO. MAIL-IN FEE 2.00
6030 CULLIGAN WAY
MINNETONKA, MN 55345- TOTAL 53.42
(952)912-7379 Payment(s)
CRED[T CARD 5107 53.42
OWNER
ACKERBERG, ROMY&STUART
2102 SUGARWOOD DR
LONG LAKE,MN 55356-
AGREEMENT A1vD 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[he 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 Ry gnature Date
1
08/21/2017 13:38 FAX 9529335049 CULLIGAN ➢�NTKA [�j002
�p� City of Orono FOR CITY USE ONLY
� � P.O. Box 66 Date Rece�ved: ��/ % �7�r7c75S
2750 Kelley Parkway
� ,, �, Crystal Bay, MN 55323 Permit# - � �1 ��
o` (952}249-4600—Main Approved:By
���KFSH�a� (952)249-4616—Fax � `�-
Amount�.': ' '
CITY OF ORONO -- PLUMBiNG PERM[T
(All Commercial Permits Must be Approved by the State Prior to City Approval)
http://www.dli.mn.aovlCCLD/PDF/pe plumbR�anrevapp.pdf
GENERAL 1NFORMATION ' ' ' ' `, ` , ,
1. You may apply for plumbing permits by mail or in person at the City offices. Applications will be
reviewed and a permit wilf be issued within two working days,
2. Permit cards will be sent by return mail after a review is completed. PERMITS ARE NOT VAL1D
UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN lJNT[L THE PERM13 CARD IS
POSTED ON THE JOB SITE.
3. Plumbing permits may be issued ONLY to ficensed pfumbing 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. Alf work must be done in accordance with State Code requirements.
6. AI!work must be inspected and air tested before it is covered. Call (952)249-4600.
(24�48 hour notice required}
, ,, ,
: TYPE OF PERMfT(CFieck A!I That:Apply) '
�Residential ❑ Commercial (Approva! Required) [Backflow Device: �AVB ❑PVB]
❑ New ❑Additional ❑ Repairs �Replace
❑ ln Accessory Structure?
*You will neecf prior approvaf and may need CUP. (Per Orono City Code, Chapter 78, Article 1�
Job'$ite/Owner;',Information:;:
SiteAddress: o�� �� S�4 ar W Ood1 riv�
Owner: b M A��..t� ��r Mailing Address:
City: Zip:
Home Phone: Alternate Phone: �� � - �� � - �a��
Contractor:lnformation ;_,
Contractor: Contact Person:
.u��IGAN WAT�p CONDITIONIN '
Address: 603o cuL����� yuqy �tate Bond #:
MI�INET4NKA, MN 5,345
City: (9�?y 933-7200 Zip: �xpiration Date:
Phone: Alternate Phone:
❑ Insurance — Current:
Page 9
• 08/21/2017 13:39 FAX 9529335049 CULLIGAN MNTKA �J003
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,�,�.�l�1Bl{�1�, TI�RE�
FIXTURE BSM7 1sT 2"o OTHER FIX7URE BSMT 1sT 2ND OTHER
TYPE Fioor Floor 7YPE Floor Floor
Water Cioset Floor Drains
Lavatory Sewer Ejector
Bathtub Laundry Tr�y
Shower Washer
Kitchen Sink Water Heater
Disposal Wafer Softener (
Dishwasher Wet Bar
Siflcocks Miscellarieous
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1. CONTRACT PRICE * is 1.25% of contract price with a (Minimum Fee of 550.00)
a8`�9 �a x .o�2s � 6s. i� I
(contract price) (minimum $50.00)
2. STATE SURCHARGE
x .0005 $ � •y �
(contract price)
3. POSTAGE � HANDLiNG {Only on Mail-In Appli�ations) $ 2.00
4. TO7AL PERMIT FEE (Add Lines 1=3 Above) $ ��• d�
* CONTRAC7 PRICE or JOB COST means the actual or estimated dollar amount charged for the
permitted work including mat�rials, labor, profit, and other fixed costs. It is the amount to be charged to
the customer for the work done. If any material, equipment, labor or installations are furnished by the
owner, tenant or any other party, the reasonable market value of such items rrtus# be added to the
estimated cost or contract price for permit fee purposes. 1n.the event that there is a dispute on the
amount of the job cost, the City may request fhe 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 al! 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.
Applicant's Signature: � Date: �'01 � - I �
Buiiding Officiall lnspector. Date:
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