HomeMy WebLinkAbout2016-00198 - water softner . CITY OF ORONO * 2 0 1 s - 0 0 1 9 e *
� 2750 KELLEY PARKWAY DATE ISSUED: 02/29/2016
ORONO,MN 55356-
(952)249-4600 FAX: (952) 249-4616
ADDRESS : 3011 SUSSEX RD
pI� : 04-117-23-32-0018
LEGAL DESC : FOX BEND
: LOT 007 BLOCK 002
PERMIT TYPE : PLUMBING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION PE : WATER SOFTENER
NOTE: REPLACE WA R S TENER
VALUATION OF PL MB G 1050
�P ICANT PLUMBING FIXTURE FEE 50.00
STATE SURCHARGE PLBG(VALUATION) 0.53
ROBERT B.HILL C . MAIL-IN FEE 2.00
7101 OXFORD ST ET TOTAL 52.53
MINNEAPOLIS, 5�42
(952)925-1444 Payment(s)
Minnesota State Lice se#: UIL-WC646096 CHECK 049259 52.53
NER
CRIS'TIANI,JUAN RE E
3011 SUSSEX RD
LONG LAKE,MN 5 35Cr
AGREEMEN AN SWORI�i STATEMENT
The work for which this rmit i sued shall be performed according to
the approved plans and s cificat s,applicable City approvals,and the
State Building Code. Thi permi for only the work described and dces
not grant permission for dition I or related work which requires separate
permits. All provisions o laws ordinances governing this type of work
shall be compied with w ther o ot specified herein.This permit will
expire and become null d void construction authorized is not
commenced within 180 ys of date of issuance,or if construction is
suspended for a period o 180 da at any time aRer work has commenced.
The applicant is responsi le for uring all required inspections are
requested in conforman with State Building Code.This permit may be
revoked at any time for d e caus . �
� �-� - � ,a �; /�
Applicant Permitee Si atur Date I ue Signature Date
, . �.p� C y of Orono ':; �'��t�I'fY��Y �
� P. . Box 66 l��te R�t;����d :�"' '" ,�3 "..- �� =
27 Kelley Parkway �C��� ��
.� C tal Bay, M N 55323 P����'' �'���" ����� � ,:
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�'� �� (9 )249-4600—Main ��r������ s, ..:
���'�sxo�-`` (9 )249-4616—Fax � �`� ��1� `
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CITY OF ORONO — PLUMBING PERMIT
(A I Commercial Permits Must be Approved by the State Prior to City Approval)
http://www.dli.mn.qov/CCLD/PDF/pe plumbplanrevapp.pdf
;��r���� F n���io� �
1. You ay a ply for plumbing permits by mail or in person at the Ciry offices. Applications will be
revie �d d a permit will be issued within two working days.
2. Perm t�ar will be sent by return mail after a review is completed. PERMITS ARE NOT VALID
UNTI YO RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS
POS D THE JOB SITE.
3. Plum irhg rmits may be issued ONLY to licensed plumbing contractors and to property owners
residi g in e dwelling.
4. Whe any ew construction or remodeling is involved, a separate building permit must be obtained.
5. All w rk m t be done in accordance with State Code requirements.
6. All w rk m t be inspected and air tested before it is covered. Call (952) 249-4600.
(24-4 ho notice required)
'T'YPE OF PERMIT(�hecic�lI That�ply�
�Reside i�l • ❑ Commercial (Approval Required) [Backflow Device: ❑AVB ❑PVB]
❑ New ❑ Additional ❑ Repairs �Replace
❑ In Acce so tructure?
*You il n d rior a roval and may need CUP. (Per Orono City Code, Chapter 78, Article IV)
,�o� �ite/ ` e nformatic�n:
Site Addres : \ `(DYlO S
Owner: � ^ Mailing Address: `3�\���g�„� ZC�
c�ty: z�p: ,�53�
Home Pho : - O Alternate Phone:
Con�t'act+�r� or �ttc�n, '':.
Contractor: �� Contact Person:� L�.�1\��� ��.Q�(Y�I�JC
�..
Address: - State Bond #: � CIo�C�j�O
,
City: Zip: �5��L o Expiration Date:
Phone: — Alternate Phone:
� Insuran — rrent:
Page 1
FIXTURE MT 1sT 2ND OTHER FIXTURE BSMT 1sT 2ND OTHER
TYPE Floor Floor TYPE Floor Floor
Water Closet Floor Drains
Lavatory Sewer Ejector
Bathtub Laundry Tray
Shower Washer
Kitchen Sink Water Heater
Disposal Water Softener �
Dishwasher Wet Bar
Sillcocks Miscellaneous
1. N CT PRICE * is 1.25% of contract price with a (Minimum Fee of$50.00)
'�, � ���•�� x .0125 $ �O • ��
(contract price) (minimum $50.00)
2. 14T SURCHARGE
�loS�. � X .000s $ oo �ot�
(contract price)
3. P ST E 8� HANDLING (Only on Mail-In Applications) $ 2.00
4. T TA PERMIT FEE (Add Lines 1-3 Above) $ �es3
* CONTRA T P ICE or JOB COST means the actual or estimated dollar amount charged for the
permitted w rNc in luding mat�rials, labor, profit, and other fixed costs. It is the amount to be charged to
the custom r for e work done. If any material, equipment, labor or installations are furnished by the
owner, tena t� or ny other party, the reasonable market value of such items must be added to the
estimated c slt o contract price for permit fee purposes. In the event that there is a dispute on the
amount of t e jo cost, the City may request the submission of a signed copy of the actual contract.
The undersi ned ereby applies to the City for issuance of a Plumbing Permit, agrees to do all work in
strict accor anc ith the ordinances of the City and the regulations of the State of Minnesota, and
certifies that all s tements made on this application are complete, true and correct.
Applicant's igna Date:
Building Offi ial/ spector: Date:
Page 2
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CERTIFICATE HO ER GANGELLi�I'1''IOi�
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AUTHORIZED REPRESENTATIVE
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