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Home My WebLink About2011-00395 (plumbing) . CITY OF ORONO PERMIT NO.: 2011-00395 2750 KELLEY PARKWAY ORONO, MN 55356- DATE �ssuEu: 05/26/20ll 952 249-4600 FAX: 952 249-4616 ADDRESS : 3382 BAYSIDE RD PIN : OS-117-23-14-0069 LEGAL DESC : BAYSIDE ADDN TO LAKE MINNETONK : LOT MB BLOCK MB PERMIT TYPE : PLUMBING (>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIXTURES-MULTIPLE NOTE: 1 WATER SOFTNER AND I IRON FILTER VALUATION OF PLUMBING 3100 APPLTCANT PLUMBING FIXTURE FEE 50.00 CLEARWATER SYSTEMS, INC. STATE SURCHARGE PLBG(VALUATION) 1.55 1519 148TH AVE NW ANDOVER, MN 55304 TOTAL 51.55 (763)434-0445 Minnesota State License#: 61240 OWNER HUTHWAITE, MICHAEL&MARILYN 7155 AINSWORTH DR GERMANTOWN, TN 38U8- AGREEMENT AND SWORN STATEMENT Thc work for which this permi�is issued shall be performed according to the approved plans and specitications,applicable City approvals,and the S[ate E3uilding Code. This permit is for only the work describcd and does not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances governing this type of work shall be compied wi[h whe[her or not specitied herein.This permit will expire and become null and void if construction authorized is not commenced within l80 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responst�te f�r assuring all required inspections are requested in conform�fice with'the State Building Code.This permit may be revoke¢� any tirq�for�ca ,in .-�:,�_��/ �/ :�. �"� � � / / icant P ' e Signature Date Issued By ignature ate SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E. FOR C1TY USE ONLY ` �,�`� City of Orono � O� `VO\ P.O.Box 66 Date Received: Yermit# � � � 2750 Keliey Parkway '�� i�p;�;�=- � ' Crystal Bay,MN 55323 Approved By: Amount$: ��^ 'i�*,,��n,,�.�o` (952)249-4600—Main �asxa$ (952)249-4616—Fax CITY OF ORONO - PLUMBING PERMIT (All Co�nmercial Permits Must be Approved by the State Prior to City Approval) htt�://��w��.dli.mn.�ov/CCI,D/�'Dl�/ e lumh lanreva }.�df GENERAL 1NFORMATION 1. You may apply for plumbing permits by mai] or in person at the City offices. Applications will be reviewed ai�d a pernut 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. PlumbinQ permits may be issued ONLY to licensed plumbing contractors and to property owners residing in the dwelling. 4. When any new consri-uction ar 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 ❑ Commercia] (Approval Required) . �New ❑ Additional ❑ Repairs ❑ Replace ❑ In Accessory Structure? *You will need prior approval and may need CUP. (Per Orono City Code,Chapter 78,Article IV) Job Site/ Owner Information: Site Address: �3 y s�� l-� Owner:�i7"7�.� .�IC'ti�i4�-� �� Mailing Address: City: Zip: Home Phone: Alternate Phone: Contractor Infonnation: Contractor:� � � t � Contact Person: /�}� Address: �,�� '"� /t�T�1. N� State Bond #: `t. ��`z �� City: ,��d��-� Zip��'�Expiration Date: ��- 3� � � Phone: �� -T�T ��''�� Alternate Phone: ❑ Insurance— Current: 1 PLUMBIN�G FIXTURES BEING INSTALLED � j FIXTURE BSMT 1' 2 OTHER FIXTURE BSMT 1' 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 Miscellaneou � � PERMIT FEE CALCULATION(S) � � � BASED OFF - 2002 STATE STATUE ❑ Yes, this secrion applies The replacement of only one Residential fixture or ap�liance 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; excludin�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 � � � PERMIT FE�E�CALGULATION(S)�—JOBS OVER $500.00 ` � � `�� -" If above does not apply;follow guidelines be]ow: 1. COl�'TRACT PWCE *is 1.25%of contract price with a (Minimum Fee of$50.00) �U� x.0125 $ (contract price) (minimum$50.00) 2. STATESURCHARGE x.0005 $ (contract price) 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 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. PLUNIBING PERMIT APPLICATION AGREEMENT The undersib ed 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 stat��ents m�d� on�.this application are complete, true and correct. 1f �� rM. / '� �f .' � ,! � / �`/,;�� `i'�/� /�/ `*��''`°�',.L / � i�' i � �SYL � Applicant's Signature � Date: � � � � - i,�� 3