The URL can be used to link to this page

Home My WebLink About2012 - 00655 - plumbing 1111111111111111111111111111111111111 111111E11111 CITY OF ORONO * 2012 - 00655 * 2750 KELLEY PARKWAY DATE ISSUED: 07/11/2012 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 993 WILDHURST TR PIN : 07-117-23-12-0003 LEGAL DESC : UNPLATTED 07 117 23 : LOT 000 BLOCK 000 PERMIT TYPE : PLUMBING(<$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIXTURE NOTE: WATER SOFTENER APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00 CULLIGAN SOFT WATER SERVICE CO. STATE SURCHARGE PLBG(<$500) 5.00 6030 CULLIGAN WAY MINNETONKA,MN 55345 MAIL-IN FEE 2.00 (952)912-7379 TOTAL 22.00 PAID WITH CC# 489 OWNER STROMBERG,JEFF 993 WILDHURST TR MOUND, MN 55364 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 cau . 6/24. � .. 71 // // ?- Applicant Permitee Signa ure Date Issuf By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 07/10/2012 14:38 FAX 9529335049 CULLIGAN MNTKA 0002 FOR CITY IJSE ONLY City of Orono O 0 P,O.Box 66 Date Received: Permit 2750 Kelley Parkway 44;1-'t_ A roved By: Amount S: k. Crystal BayNN 55323 PP �.a (952)249-4600 CITY OF ORONO—PLUMBING PERMIT (All Commercial permits must be approved by the Building Official or Inspector) GENERAL INFORMATION 1. You may apply for plumbing permits by mail or in person at the City offices. Applications will be reviewed and a permit will be issued within two working days. 2. Permit 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 Apply) Residential D Commercial(Approval Required) ❑New ❑ Additional ❑ Repairs XReplace ❑ In Accessory Structure? *You will need prior approval and may need CUP.(Per Orono City Code,Chapter 78,Article IV) Job Site/Owner Information: n Site Address: 99 3 Aal, u.+(s-- ` rat , Owner: 1\r NI u` K to c er Mailing Address: City: Zip: S536-f Home Phone: Lia -94t- 7-1g Alternate Phone: Contractor Information: Cu�.�.nl YrWATER GONDITIOi�TfN Contact Person: f l> V 6030 CULLIGAN WAY State Bond #: A*I4F JETONKA, MN 55345 - (952) 933-7200 City: Zip: Expiration Date: Phone: Alternate Phone:. 5 - I - 73 I 1 . 0 Insurance—Current: - 1 07/10/2012 14:38 FAX 9529335049 CULLIGAN MNTKA 21003 • VAI:�,., ,... . .. .., .. V,.,O0 i .... .......,,.. '"!J:Y;;S:CI;'>'0:4P.. ,. FIXTURE BSMT 1ST 2ND OTHER FIXTURE BSMT 1ST 2 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 Bar Sillcocks Miscellaneous • dk.•. E nl, .� ' ai! F ° 9 I:��i � i�•' jl(:'lY�'• }�K '• �J ,.� � sl..r � �' !l�1117,='t i r r �J ' i`' ti 7. .044.t4'.744,5,-,,,a--4,476 ka ! IT 0gy x;tuaPu ,i . ?,w.:.. � Yes,this section applies The replacement of a 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;excluding the cost of the fixture or appliance:and 3. Is improved,installed or replaced by the homeowner or licensed 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 S (Permit Fees Continued On Next Page) 2 07/10/2012 14:38 FAX 9529335049 CULLIGAN MNTKA 1 j004 .0 n47�ie,'rd nG{t'7 i��..n ,.�� :p�`rHt,. ._ .�I �, •ci.,, gi�'� :r� t�•i'ff��.,41x:`d�y�rrr .:�1e Y.{�.l'ftf�n.,..A_: ;� )�•'�N,y:.�� ?^T.':t l � .,s �. .> �.:.i �'ffr,�r.,i'.�o,i•�";b... If above does not apply;follow guidelines below: 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$50.00) x.0125$ (contract price) (minimum$50.00) 2. STATE SURCHARGE **Add the State Bldg Code Div.Surcharge(Minimum Fee of$5.00) x.0005 $ (contract price) (minimum$ 5.00) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2,00 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ 00! �U ■ * CONTRACT PRICE or JOB COST means the actual or 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 installations 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 City may request the submission of a signed copy of the actual contract. • **The STATE SURCHARGE is .0005 of the contract price under$1,000,000 or$5.00—whichever is greater. For valuations over$1,000,000 call the Building Department at(952)249-4600 for the price. 5:, 1!?q ;$,.. 1 � :tl t� n�7,r h �� dl ��iit3(��j�l{b ��'i �w �� '.y`, � �a� b ' �f h+cr� t��t..<421G.� .R��},r�„w.�. t,�,.d..,,�..G ,�r.�,:...°�.,..�.�.95.. �„ �. i- Y r��,•�.. 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 certifies that all statements made on this application are complete, true and correct. C. Applicant's Signature: it. Date: I - 3