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Home My WebLink About2012-00362 - water softner - � CITY OF ORONO * 2 PJ 1 2 - 0 0 3 6 2 * � 2750 KELLEY PARKWAY DATE ISSUED: OS/03/2012 ORONO, MN 55356- 952 249-4600 FAX: 952 249-4616 ADDRESS : 3190 SUSSEX RD PIN : 04-117-23-32-0007 LEGAL DESC : FOX BEND : LOT 001 BLOCK 001 PERMIT TYPE : PLUMBING(<$500) PROPERTY TY E : RESIDENTIAL CONSTRUCTI N TYPE : WATER SOFTNER � � � APPLICAI�TT PLUMBING FIXTURE FEE(<$500) 15.00 RICHARD'S C STOM WATER STATE SURCHARGE PLBG(<$500) 5.00 6121 EXCELSI R BLVD.#206 ST. LOUIS PA K, MN 55416- TOTAL 20.00 (952)920-1200 Minnesota Stat License#: WM061456 OWIVER KENNEY,JO N& MARY 3190 SUSSEX LONG LAKE, 55356- AGREE ENT AND SWORN STATEMENT The work for whi h this permit is issued shall be performed according to the approved plan and specifications,applicable City approvals,and the State Building Co e. This permit is for only the work described and does not grant permiss' n for additional or related work which requires separate permits. All prov sions of laws and ordinances governing this type of work shall be compied ith whether or not specified herein.This permit will expire and beco null and void if construction authorized is not commenced with 180 days of the date of issuance,or if construction is suspended for a p riod of 180 days at any time after work has commenced. The applicant is r s sible for assuring all required inspections are requested in c ance with the State Building Code.This permit may be revoked n i e for d ca _ o�'� 03 , � � i i Applicant Per itee S' nature Date Issued By " nature SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO . : i � ' FOR CITY USE ONLY , � City of Orono - O4 �O P•O.Box 66 �\� Date Received: Yermit# �;, 2750 Kelley Parkway � �? a � �� Crystal Bay,MN 55323 � Approved By: Amount$: d� ��,��ii��G� (952)249-4600—Main � �so$ (952)249-4616—Fax � CITY OF ORONO - PLUMBING PERMIT (All Commercial Permits Must be Approved by the State Prior to City Approval) htt ://ww��.dli.inn.�rov/CCLD/PI)F/ e � lumb lanreva� �. df ENERAL INFORMATION ' 1. You may apply for plumbing permits by mail or in person at the City offices. Applications will be reviewed and a pernut will be issued within two working days. 2. Pernut cards will be sent by return 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 State Code requirements. 6. All work must be inspected and air tested before it is covered. Call(952)249-4600. (24-48 hour notice required) ' TYPE OF PERMIT (Check All That A ly) � � �sidential ❑ Commercial(Approval Required) i ❑ New ❑ Additional ❑ Repairs ❑Replace I ❑ In Accessory Structure? � *You will need prior approval and may need CUP. (Per Orono City Code, Chapter 78,Article IV) I� Job Site/Dwner Information: � �-� Site Address: 5 � C/v � � �S�,rX �1� � � Owner: �b�N �`✓�� d�C��U/u�Mailing Address: City: �� D�� Zip: � Home Phone: ��/Z ' � 7�� Z Alternate Phone: Contractor Information: .� I Contractor: /�`NA�j�s ��Ta� Contact Person: ��i'��/y� GC�iO TpY— Address: ��2� C'X GG2.Si e� /✓PGdo State Bond#: City: �'�"�^-'��S Zip:S�� ExpirationDate: Phone: 9) Z �Z� ��v Alternate Phone: ❑ Insurance– Current: 1 ' � ! � �:�;�._=, � ,: :�� PLUMBING FI�TURES'B'�"�.`�G 1NSTALLED � �� ` �� z��,.,� �I FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 2 OTHER TYPE FL FL TYPE FL FL Water Closet Flo or Drains Lavatory Sewer Ejector Bathtub Laundry Tray Shower Washer Kitchen Sink Water Heater Disposal Water Softener Dishwasher Wet Bar Sillcocks Miscellaneous � � �� PERMIT FEE CALCULATION(S)� � BASED OFF -2002 STATE STATUE ❑ Yes,this section applies The replacement of only one Residential fixture or appliance that meets all three of the following requirements: 1. Does not require modification to electrical or gas service. 2. Has a total cost of$500.00 or less; excludine the cost of the fixture or appliance: and ; 3. Is improved, installed or replaced by the homeowner or licensed plumbing contractor. Skip next section, if this applies; Cost of Permit $ 15.00 � State Surcharge $ 5.00 Mail-In Fee(If Applicable) $ 2.00 Total Permit Fee $ (Permit Fees Continued On Next Page) 2 {' f � � t . :, ER`N'IIT�"�;CALCULATION S —JOBS OVER$500 00 �� . a,�. ,, �� m, I above does not apply; follow guidelines below: 1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00) x.0125 $ (contractprice) (minimum$50.00) 2. STATE SURCHARGE x.0005 $ (contract pnce) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the pernutted 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 installations are furnished by the owner, tenant or any other party, the reasonable market value of such items must be added to the esrimated cost or contract price for permit fee purposes. In the event that there is a dispute on the amount of the job cost, the City may request the submission of a signed copy of the actual contract. � PLLTMBIl�T i ��" ��'�T ��'N,�`.� � �;; IThe 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 certifies that all statements made on this application are complete, true and correct. Applicant's Signature: � � Date: � � �� 3