HomeMy WebLinkAbout2009-00854 (plumbing) . CITY OF ORONO PERMIT NO.: 2009-00854
' 2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUED: 1 U30/2009
952 249-4600 FAX: 952 249-4616
ADDRESS : 3420 BAYSIDE RD
PIN : OS-117-23-13-0012
LEGAL DESC : AUDITOR'S SUBD.NO.203
: LOT 020 BLOCK 000
PERMIT TYPE : PLUMBING(<$500)
PROPERTY TYPE : RESIDENTIAL
� CONSTRUCTION TYPE : WATER SOFTNER
APPLICANT PLUMBING FIXTURE FEE(<$500) I5.00
CULLIGAN SOFT WATER SERVICE CO. STATE SURCHARGE PLBG(<$500) 0.50
6030 CULLIGAN WAY
MINNETONKA, MN 55345 MAIL-IN FEE 2.00
(952)933-7200 MISC FEE 0.00
TOTAL 17.50
PAID WITH CC# 0597
OWNER
MILESKI &APRIL NEWTON,BLAIR
3420 BAYSIDE RD
LONG LAKE, MN 55356-
AGREEMEIVT AND SWORN STATEMENT
The work for which this permit is issucd shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
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Applicant Permitee Signature Date Issued By ignature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO .
11/30/2009 11 11 �AX 9529335049 CULLIGAN MNTKA C�002
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FOR CITY TJSE ONLY
�Q� City of Orono
P.O.Box 66 Date Received: Permit#
��: � 2750 Kelley Pazkway
�"���r A roved'B Amoiant$:
� ,1 Crystal Bay,MN 55323 PP Y�
�u `'��r�� (952)149-4600 �
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CITY OF ORONO—PLUMBING PERNIIT
(All Commercial pecmiu must be approved by the Building Offieial or Inspector)
ENERAL:IN�'ORMATION , � ' -
1. You may apply for plumbing permits by mail or in person at the City o�ces. Applications will be
reviewed and a permit will be issued within two working days.
2. Permit cards will be sent by retum mail after a review is completed. PERMITS ARE NOT
VALID UNT1L YOU RECETVB A PERMIT. WORK MUST NOT BEGIN UNTIL THE
' PERMIT CARD IS POSTED ON THE JOB SITE.
', 3. Plumbing permits may be issued ONLY to(icensed plumbing contractors and to property owners
residing in the dwelling.
, 4. When any new construction or remodeling is invoived,a separate building permit must be
Iobtained.
S_ All wo�k 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)
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I ❑ mmercial(Approval Required)
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, ❑New ❑Additional ❑Repairs �Replace
I ❑ In Accessory Structure7
*You will need orior anproval and may need CU .(Per Orono City Code,Chapter 78,Article N)
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Site Address: 3y clO I.���s� � f�
pwner: Q�o�►r I��le,s k� Mailing Address:
�2ty: Zip: .5535
ome Phone: 61�� b7 0 � 3d�L3 Altemate Phone:
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ontractor: Contact Person:
d�ess� 603 �Ar�R CONDITIONfNG State Bond#:
MINNETONKA, MN 5�45 Expiratioii Date:
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hone: Alternate Phone: �'S a-91 a - 73��
❑ Insurance—Current:
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11/30/2009 11:11 FAX 9529335049 CULLIGAN MNTKA l�003
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FIXTURE BSMT 1 2 OTIIER FIXT[JRE BSMT 1 2 OTF�R
i 'rypE FL FL TYPE FL FL
� Water Closet Floor Drains
ILavatory Sewer Ejector
athroom Laundry Tray
Shower Washer
Kitc�en Sink Water Heater
DispPsal Water Softener '
DishNvasher Wet Bar
Sillcpcks Miscelianeous
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� Yes,this sectian applies
The feplacement of a Residential fixture or appliance that meets all three of the following requirements:
� 1. Does not require modification to elactrical or gas service.
' 2. Has a total cost of$500.00 or less;excludin�the cost of the fixture or appiiance: and
3. Is improved,installed or replaced by the homeowner or licensed contractor.
I
j Skip next section,if this applies; Cost of Permit $ 15.00
� ' State Surcharge $ .50 .
Mail-In Fee(If Applicable) $ 1.50
I Total Permit Fee �
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(Perfnit Fees Continued On Next Page)
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11/ /200� 11:11 FAX 9529335049 CULLIGAN MNTKA [�004
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If above does�ot apply;follow guidelines below:
I. CONTRACT PRTCE * is 1,25%of contract price with a(Minimum Fee of 535.00)
x.0125 $
(conVact Price) (minimum$35.00)
2. STATE SURCHARGE **Add the State Bldg Code Div.Surcharge(Minirnum Fee of 5.50)
x.0005 $
(contract price) (minimum$ .50)
3. POSTAGE&I��ANDLING(Only on Mail-In Applications) $ .�� o�•V U
4. TOTAI.PERNdIT FEE(Add Lines 1-3 Above) S �7 �SV
■ * CONT�ACT PRICE or JOB COST means the actual or estimated dollar amount charged for the
permitted work including materials, tabor,profit,and other fixed costs. It is the amount to be charged
to the cu$tomer for the work done. If any material, equipment, labor or installations are furnished by
the owner,tenant or any other pautyy,the reasonable market value of such items must be added to the
estimatec� cost or contract price for permit fee purposes. In the event that there is a dispute on the
a�nount 9f 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$1,000,000 or$.50—whichever is
greater. �'or valuations over$1,000,000 call the Building Department at(952)249-4600 for the price,
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The undersi�ned 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
Mumesota, and certifies that all statements made on this application are complete, true and
correct.
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Applicant's signature: Date: ��"�� � I
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