HomeMy WebLinkAbout2009-00345 - vacuum breaker �. CITY OF ORONO PERMIT NO.: 2009-oo34s
� 2750 KELLEY PARKWAY
+ ORONO, MN 55356- DATE IssuEn: 06/22/2009
952 249-4600 FAX: 952 249-4616
ADDRESS : 2116 SUGARWOOD DR
PI N : 34-118-23-21-0028
LEGAL DESC : SUGAR WOODS
: LOT 000 BLOCK 000
PERMIT TYPE : PLUMBING(<$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : VACUUM BREAKER
NOTE: VACUUM BREAKER-BACKFLOW PREVENTER FOR IRRIGATION SYSTEM
APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00
WOODBURY MECHANICAL, INC. STATE SURCHARGE FLAT-OTHER 0.50
1988 STANICH CT TOTAL 15.50
MAPLEWOOD,MN 55109-
OWNER
Sugarwoods Homeowners Association
PIGNTENS, C/O FRANK
2007 SUGARWOODS 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 governing 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 fot 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 ermitee Signature Date Issued By gnature Date
SEPARATE PERM[TS REQUIRED FOR WORK OTHE THAN DESCRIBE V .
Jun-19-1009 08:22am From-CITY OF ORONO +9512494616 T-592 P.001/003 F-526
' O�Q� City of Orono ' ' : . ,�R CITX�USE ONLY : • .
P.O.Hon 66 . � .
0 '.�u�lteceivo�:. �• � • •Permit � .
2750 Kelley Pukway . . .'�r :.; ,,�-'=—�-' �( �
� � �ystal Dsy,MN 55323 Approved Ry;(If ume �
(9S2)_49�4600 � � ^): ..
CIT`Y OF ORONO,WATER 1VIETER�'OR1VI
(`Note:Sor�permiie tta�y rrquiro approval by d�c IIuilding OfMicial and�or Public W,xka D,,pArnni„t•)
CF.T�ERA�,Ii�'FORMATION , � . . � . . .
1. Wq7'�R METERS mu,ct be picl�d up a�p��d for at City HaU.
2. Yf ' Ic fiuc ia this applicarion al�ad of time;we wi11 cl:en caIl you and 1et you laww we havc
the�u'e�er mrur in stock. �ax Number:(952)249-4616. Also,you cnn cali aluad of tia�e to rnalce
sure we received the fax,or to warn«s that tbe fax is comir�g,
3. WATEYt 11�TERS must be �et snd seAled by Orono VNater �p�rtmcnt (9ga� 249-46Q0,
upoa completion oi meter insta,Uadon.
� � . � . , � .� � : . �P$ofi PE�vrrr � � .
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� �• � � ' Check Ail'Y'hat A l • � � , �
❑Residcntial(May Require ppproval) ��nia1
�i (APP���qui red)
❑New Metcx []pddihoaal Mettr,For:
❑1t,e1�lacement Me�rr
Job Site/Owner b�formaaon;
Sitc Adc3ress: �G ��
Owaer: Mailing Address:
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City: � Zip:
Home Phone: Alternate Phone:
Coi�tractor•Infor�tlation: � . .
Contractor: �j(.� � �Contact P�son: �!1 � ��(c
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Address: ��l' a- State License#: ,�� _ P/�
Ciry: ��J��i+�i� ZzP:_S3'�9 Expiration bate: � 3/ '-" 4
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Phone: GS�`�- 79�� Alternate phone: �S/- 7 7S"�- 6p `��'
Jun-19-2009 08:22am From-CITY OF ORONO +9512494616 T-592 P.003/003 f-526
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❑ S18"METER- ❑ 3/4"MET'ER-
❑ 5/8"lyORN - ❑ 3/4"HOttN - 1��METER-
r—� � 1"i�ORN .
�—J "WATER MET$Yt (TH�SE WILL HAVY�:TO Y!F SAE(:1nL pRpEREn&Pk�r�S pE7eRMltvED)
1. MP.TER 1�E:
S
2. HORN FEE
$
3. TOTAL pERMI'I'�'EE{Add Lines 1•2 Above)
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CITY-USE ONLY
*For Current Pricing Refer to Current Yeaz-Water Meter Pricing Chart *
BTtANb;
SIZE: [�5/8" []3/4" [�ii„ (]OWer „
SERUIL�: S I �-/(�
EItT HIG�#: � III III IIII I II II IIIII I II I IIIII
1820458093 ��'appl�cable)
: ADDIT�ONAL INF'4RMATTON�WATER METERS . � .
The undersigned hereby applies to the City of Orono for issuaxtce �f a water met�r permit, agrees
to do all wark in strict accordance with the ordinances of the City and t,he regula�ions of the StAte
of Minnesota,ar�d cerCifies th2t a11 statements made on this application are,txue and correct.
Applicant: " �
Date:
—��..�,
Original: /-Addrers File
Make G'opies For: 1-Utiliry Bi!lingDepartment 1-Cp►h Drpwer
�A�( �T� T TIME �
CITY OF ORONO CALLED IN � ��'
INSPECTION NOTICE SCHEDULED � ��
PERMIT NO.c��OQ Gb,.35�rP COMPLETED
ADDRESS � �
OWNER CONTR. L����'l
TELEPHONE NO. ��0 3 - ��T 3 �7QL�
¢ V4C�M
� DESCRIPTION r� l ��
� ❑ FOOTING ❑ E ANICAL RI ❑ EXCAV/GRADING/FILLING
Q ❑ FRAMING ❑ HANICAL FINA� ❑ LAKESHORE/WETLANDS
y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL
Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
v ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOILOW-UP
_ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL
Z OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� �ORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� �CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWlTHIN HOURS. p pHOTOTAKEN
INSPECTOR WFLL RETURN
�STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑IIJSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call forthe next inspection 24 hours in advance. (952) 249-46��
Owner►Contractor on site: /
Inspector.
White Copylinspecto�'s File Canary CopylSite Notice