HomeMy WebLinkAbout2003-P06317 - plumbing CITY�OF R N PERMIT
O O O Permit Number:
27�0 Kelley Parkway- PO Box 66 P06317
Crystal Bay, Minnesota 55323 Permit Type: FiXtu�es
(952) 249-4fi00 Date Issued: 5/14/2003
SITE ADDRESS: 460 Sussex La
Long Lake,MN 55356
P I D: 04-117-23-31-0012
DESCRIPTION:
Proposed Use: Kesicientiai
Permit Class: Plumbing
Permit Type: Fixtures Permit Sub-type(s): Mulriple Fixtures
DETAILS:
Approved per resolurion#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Pernut Fee: $ 44.69 Valuation• $ 3,575.00
State Surcharge Fee: $ 1.79
TOTAL FEE: $ 46.48
APPLICANT: Plymouth Plumbing&Heating OWNER: Daron&Kerry Meyer
6909 Winnetka Avenue N 460 Sussex La
Brooklyn Park,MN 55428 Long Lake MN 55356
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENT'S 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 ISSUED BY SIGNATURE
Covies: 1-File(SiQnitures Required), 1-Avplicant, 1-Monthlv Renorts, 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 INFORMATION
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 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. 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 249-4600. 24-hour notice required.
Instructions 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 249-4600. l� �
(,c,��.�,�� � �t;�� 't—t i 1-( ��._.
Please check one: � New Addition Repair Replace
Residential Commercial
JOB STI`E: � " � -� Zip:
Owner's Name: � Telephone Number:
Mailing Address: City: Zip:
Contractor's Name: �� �; 1�'VI. ��� Telephone Number:
Mailing Address: � City: Zip:
PLUMBING FIXTURE SCHEDULE
FIXTURE BSMT 1ST 2ND OTHER FIXTURE BSMT 1ST 2ND OTHER
TYPE FL FL TYPE FL FL
Water Closet Floor Drains
Lavatory � Sewer Ejector
Bathtub Laundry Tray
Shower Washer
Kitchen Sink ( Water Heater
Disposal Water Softener
Dishwasher ' Wet Baz �� '
Sillcocks Misc (list) I
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PERMIT I�'EE CALCULATION
1. 1.25% of Contract Price* or Minimum�Fee ($35.00) I '
'������ �� x .0125 $ � �1 ��Q�
(contract price)
2. State Surcharge. ** Add the State Building Code Division
Surcharge to each permit. ?����Cj : �� x .0005 $ ( , �]�
(contract price)
or $.50, whichever is greater
3. Posta�e and Handlin� (Only mail-in applications) $ 1.50
4. TOTAL PERMIT FEE (Add lines 1-3 above) $ � (�. �
* CONTF��CT PRICE or JOB COST means the actual o:estimated dollar amount charged for the permitted
work including materials, 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 installation are furnished by the owner,
tenant or any other party the reasonable market value of such items must be added to the 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 Cicy may request the submission of a signed copy of the actual contract.
** The STATE SURCHARGE is .0005 of the concract price under �1,000,000 or $.50 - whichever is
greater. For valuations over $1,000,000 call the Department of lnspectional Services for the price.
The undersigned hereby applies to the City 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 certi�es that all statements made on this application are complete, true and
correct.
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Applicant's Signatu • Date: � — �`1 —
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