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CITY OF ORONO
APPLICATION FOR LAWN SPRINKLER SYSTEM PERMIT
GENERAL INFORMATION
1. You may apply for sprinkler system permits by mail(P.O.Box 66,Crystal Bay,MN 55323)
or in person at the City offices (2750 Kelley Parkway). Submit plans for review with this
application.
2. PERMITS ARE NOT VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT
BEGIN UNTIL THE PERMIT CARD IS POSTED ON THE JOB SITE.
3. When any new construction or remodeling is involved, a separate building permit must be
obtained.
4. All work must be done in accordance with City and State Building Code requirements. - -
5. Two (2) sets of working plans shall be submitted for approval to the authority having
jurisdiction before any equipment is installed or remodeled. Deviation from approved plans
will require permission of the authority having jurisdiction.
Working plans shall be drawn to an indicated scale on sheets of uniform size with a plan of
the site so that they can easily be duplicated and shall show the following data:
a. Name of owner and occupant.
b. Location, including street address.
C. Point of compass.
d. Location of septic system if applicable.
e. Source of water supply.
f. Pipe size.
g. Pipe location.
h. All control valves, check valves, drainpipes.
i. Name and address of contractor.
6. All work must be inspected(final). Call (952) 249-4600.
24-Hour Notice Required
INSTRUCTIONS Complete all items on this application. Incomplete applications will not be
processed. If you have questions, call (952) 249-4600. You will be notified by phone when the
permit review is complete.
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3
Zoog ._00 Zs�
i Pleasd check one: New__Z_------Addition Limited Energy Technology
Systems License #
JOB SITE
Owner's Name i Telephone Number :�—'_3 $�y �c tr
Mailing Address
Sprinkler Contractor's Name r CS,,,LAjTelephone Number
Contact Person r I'll r-,
Mailing Address G/ �— ��1�„� c �✓ �� � , { 2 S9
WATER SUPPLY
Lake Well City
BACKFLOW DEVICE
AVB PVB
Year of
Make Model Manufacture Quanti
Sprinklers ,,, 6 PGi� d rs 3v
TOTAL
HYDRAULIC CALCULATIONS Design Data:
Area of Application: Sq. Ft.
Coverage per Sprinkler: Sq. Ft.
No. of Sprinklers:
Total Water Required: GPM
PERMIT FEE CALCULATION
1. Permit Fee $ 35.00
2. State Surcharge $ .50
3. Mail-In Fee $ 1.50
4. TOTAL PERMIT FEE (Add lines 1-3 above) $
The undersigned hereby applies to the City for issuance of a Sprinkler System Permit, agrees to do
all work in strict accordance with the ordinances of the City and State regulations, and certifies that
all statements made on this application are complete, true and correct.
Applicant _ Date -ate
***** ** **** ************ ****************************************************
Approved Approved with Corrections Denied
Reviewed By: f Date
CITY OF ORONO PERMIT NO.: 2008-00254
2750 KELLEY PARKWAY
ORONO,MN 55356- DTE ISSUED: 10/01/2008
' 952 249-4600 FAX: 952 249-4616
ADDRESS 3940 WATERTOWN RD
PIN 32-118-23-32-0001
LEGAL DESC UNPLATTED 32 118 23
LOT 000 BLOCK 000
PERMIT TYPE : SPRINKLER
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : LAWN SPRINKLER
APPLICANT
SPRINKLERS 35.00
ENERAL SERVICE
G
GE MAINE STATE SURCHARGE FLAT-OTHER 0.50
ST
MAPLE PLAIN,MN 55359 TOT L 35.50
(763)479-2585
OWNER
HEDBERG,CHRISTOPHER&HEIDI
3105 ZIRCOM LANE N
PLYMOUTH,MN 55447
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 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 ca e.- — / w //,o —/ — v
Ap cant tee ignat Date Issued y Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIB D ABOVE.