HomeMy WebLinkAbout2011 - 01135 - lawn sprinkler CITY OF ORONO PERMIT NO.: 2011-01135
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUED: 09/29/2011
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 55 WEAR LA N
PIN : 33-118-23-34-0006
LEGAL DESC : ROLLING MEADOWS 2ND ADDN
: LOT 002 BLOCK 001
PERMIT TYPE : SPRINKLER
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : LAWN SPRINKLER
NOTE: INSTALLED BY OWNER-MICHAEL KELDERMAN
BACKFLOW DEVICE-PVB
MAKE-ZURN, MODEL 720A YEAR OF MANUFACTURE-2011
60 RAINBIRD HEADS
APPLICANT SPRINKLERS 35.00
KELDERMAN,MICHAEL&JUDITH J STATE SURCHARGE FLAT-OTHER 5.00
55 WEAR LAN
LONG LAKE,MN 55356- MAIL-IN FEE 2.00
MISC FEE 0.00
TOTAL 42.00
OWNER
KELDERMAN,MICHAEL&JUDITH J
55 WEAR LA N
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 goveming 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 conforman e with the State Building Code.This permit may be
rev d at any time ford cause.
9, - 77, /1 of , , 62aLea/‘.._
Applicant Permitee Si ure Date Issu=f:y Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
• City of Orono FOR CITY USE ONLY
�V \ P.O.Box 66
2750 Kelley Parkway Date Received: ! Permit#0�* �3
MN
PhoneCrystal:(952)ay249 460055323 Fax
(952)249-4616 Approved By: Amount$: c:›2
CITY OF ORONO—LAWN SPRINKLER PERMIT
PERMIT CODES(IN-HOUSE)
Sprinkler/Residential/Lawn Sprinkler/Blank
Sprinkler/ResideentialBackflow Device Only/Blank
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Job Site Address: -S \>•i-e f.c `-a n (\)
Owner: >(-hC),k) &AC rr r Telephone Number: (o\Z-%Q I-Z33
Mailing Address: atz.0 )-Gra
City: \-%Q Zip:
Sprinkler Contractor: � c'r% 1a� ,15,er\4 elephone Number: 6\ Z 27 0 147)25
Contact Person : T, OCC0 v,� 1' , License#:
Mailing Address:
WATER SUPPLY
Lake n Well n City❑
BACKFLOW DEVICE
AVB n PVB ns+0,\\a.,.S, 0 up^ate'
Make 0- Model 7 [0, A Year of Manufacture 2.01) Quantity I
Sprinklers:
HYDRAULIC CALCULATIONS Desi2n Data:
Area of Application: Sq. Ft.
Coverage per Sprinkler: Sq. Ft.
No. of Sprinklers: 6D
Total Water Required: ( 0 GPM
PERMIT FEE CALCULATION
1. Permit Fee: $ 35.00
2. State Surcharge $ 5.00
3. Mail-In Fee $ 2.00
4. TOTAL PERMIT FEE(Add lines 1-3 above)
The undersigned hereby applies to the City of 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 9/ZO/
Approved Q Approved with Corrections Denied
4145/`-
Reviewed By: / :t. Date q � -1 1
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 to 48 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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