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Home My WebLink About2013-00116 - water softener ,A , CITY OF ORONO * z 0 1 3 - 0 0 1 1 6 * ' 2750 KELLEY PARKWAY DATE ISSUED: 02/19/2013 � ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 3205 GRAHAM HILL RD PIN : OS-117-23-14-0065 LEGAL DESC : GRAHAM HILL PRESERVE : LOT I BLOCK 1 PERMIT TYPE : PLUMBING (> $500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIXTURE Ncrr�:: wn�i�:►i i iH,n r�,►z VALUATION OF PLUMBING 9427 �. I�,�� S° �� S v� � �� APPLICANT PLUMBING FIXTURE FEE 1 17.84 HAFERMAN WATGR COND INC STATE SURCHARGE PLBG (VALUATION) 4.71 12142 12TH AVE S BURNSVILLE, MN 55337 MAIL-IN FEE 2.00 (952)894-4040 TOTAL 124.55 OWNER KISSNER, MATT&NEENA 505 S l OTH STREET MINNEAPOLIS, MN 55404- AGREEMEIYT AND SWORN STATEMENT �I'he�cork for ti�hich this pcnnit is issued shall be performed according tu the approvcd plans and specifications,applicable City approvals,and thc State Building Code. This permit is for only the work described and docs not grant permission for additional or related work which requires saparate permits. All provisions of laws and ordinanccs governing this type of work shall be compied with whether or not specitied herein.This permit will eapire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspcnded for a period of 180 days at any time after��ork has commenced. The applicant is responsible for assuring all required inspections are requestcd in confonnancc with the State Buildinb Code."Chis permit may bc revoked at any time for due cau e. C�2�_Lt.t�c�CC� d l /�l � �i �`j l Applicant Permitee Signature Date Issue [3y Signature Datc SEPARATE PERMITS REQU[RED FOR WORK OTHER THAN DESCRIBED ABOVE. + , � F�C Y USE ONLY % `� City of Orono �� fO¢ O', P.O.Box 66 Date Received. �l Pemlit# ��— ! � 2750 Kelley Parkway �� i .� i�'�• �� Crystal E3ay,MN 55323 Approved By: Amount� �� "��i �..� o`.- (952)249-4600—Main �'�x°��' (952)249-4616—Fax CITY OF ORONO - PLUMBING PERMIT (All Commercial Permits Must be Approved by the State Prior to City Approval) I�tt �:,h��r�.dli.e�i��.��us�ICf'1;D/PI)E^t>c �lurnk� �I�nreva a a.�tll' 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 BECIN UNTIL THE PERMIT CARD IS POSTED ON THE JOB SITE. 3. Plumbing permits may be issued ONLY to licensed plumbing contractars and to property owners residing in the dwelling. REG►�j�c� 4. When any new construction or remodeling is involved,a separate building permit must be 4 obtained. �� 9 [D� 5. All wark 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. (��N (24-48 hour notice required) ��F�'QNO TYPE OF PERMIT (Check All That A 1 ) ��I2esidential ❑Commercial (Approval Required) �Tlew ❑ Additional ❑ Repairs ❑ Replace ❑ In Accessory Structure? *You will need urior approval and may need<_'l;P. (Per Orono City Code,Chapter 78,Article IV) Job Site/Owner Information: , � Site Address: ��,.�� {�C��1Cx�ti�"1 � �� ;('� � Owner: �� Il�� 1�`��, Mailing Address: C,IY �1,1�� i�'� �'�`�"" � c City: �1 U(1�' Zip: �� `� ' ^ \�. . �' Home Phone: \�� C.-�,�� ` �� Alternate Phone: Contractor Information: Contracto -�-V� V1`�C� �-�/ Contact Person: Address: ` ��I�-��`1��-� State Bond #: �,��vC� City: '( � Zip��7��Expiration Date: Phone: `'��- �`�� `�—�-�C--�' Alternate Phone: ❑ Insurance—Current: 1 PLUMBING FIXTURES BEING 1NSTALLED FIXTURE BSMT 1 r 2ND OTHER FIXTURE BSMT I T 2�D OTHER TYPE FL FL TYPE FL FL Water Closet Floor Drains Lavatory Sewer Ejector Bathtub Laundry Tray Shower Washer Kitchen Sink Vl'ater Heute; 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$SGU.GG or iess;excludin�tne 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 , , � PERMIT FEE CALCULATION(S)-JOBS OVER$500.00 If above does not apply; follow guidelines below: 1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00) G�Z�; oo x .o�25 $ << � - �`( (contract price) (minimum$50.00) 2. STATE SURCHARGE i�I Z� - �i U x .0005 $ `�- � ( (contract price) 3. POSTAGE& HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PERMIT FEE(Add Lines 1-3 Abov�) $ j �-Y: S � ■ * CONTRACT PR10E 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. PLUMBING PERMIT APPLICATION AGREEMENT 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. ��^. V t_ Applicant's Signature: Date: ��,� Reset Form 3