HomeMy WebLinkAbout2008-P12154 - vacuum breaker PERMIT
CII�Y.��� ORONO
275Q Kelley Parkway- PO Box 66 Permit Number: p12154
Crysfal Bay, Minnesota 55323 Permit Type: Vacuum Breaker
(952) 249-4600 Date Issued:
6/11/2oos
SITE ADDRESS: 15 Brown Rd S Unit#
Long Lake,MN 55356
P��� 34-118-23-34-0010
DESCRIPTION:
Proposed Use: Residential
Permit Class: Plumbing
Permit Type:
Vacuum Breaker Permit Sub-type(s): Vacuum Breaker
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Pernlit Fee: $ 35.00 valuation: $ 0.00
State Surcharge Fee: $ 0.50
Misc.Fee: $ 1.50
TOTAL FEE: $ 37.00
APPLICANT: Drain Pr Plumbing Inc. OWNER: John&Bonnie Eiss
8815 W 209th St. 15 Brown Rd S
Lakeville,MN 55044 Long Lake MN 55356
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
/rC.�.�-�. �.
APPLICANT PERMITEE SIGNATURE 1 ED BY SIGNATURE
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septiq 1-Septic) Page 1
.-
�
Please check one: New Addition� Limited Energy Technology
Systems License #
JOB SITE I� �COl1�(� � ��
� ��Owner's Name ^ (�h �S Telephone Number — � � �' �f
Mailing Address �,� C (� " � � ,
SprinklerContractor'sName C� I �, `1� /��lephoneNumber q�—��9 "''�--��-2�
Contact Person ��+(1 Yl
MailingAddress �g�, � -1 h `" (i°� �� ��
WATF.R SUPPLY �5���
Lake �'�'el] Cit�i�
BACKFLOW DEVICE
AVB PVB��
Year of
Make Model Manufacture uantit
Sprinklers �'6 (Y�(��t l��� � --d� �
TOTAL
HYDRAULIC CALCULATIONS Design Data:
Area of Application: Sq. Ft.
Coverage per Sprinkler: Sq. Ft.
No. of Sprinklers:
Total Water Required: GPM
PERMIT FF,E CALCULATION
1. Permit Fee $ 35.00
7. Ct�t" �UI'''f:'d''cr� ,p .Jr`V
3. Mail-tn Fee $ 1.50
4. TOTAL PERMIT FEE (Add lines 1-3 above) $
The undersigned hereby applies to the City for issuance of a Sprinkler System Permit, agrees to do
all work in strict accordance with the ordinances ofthe City and State regulations,and cer�ifies that
all statements made on this application are complete, true and correct.
�"1
Applicant ��� :�"� Date �p — ���
��,
****************************�:****************************************************
Approved Approved with Corrections Denied
Reviewed By: Date
k Reset Form
�f
�� �—J DAT TIME ✓
CITY OF ORONO CALLED IN � ��
INSPECTION N IC SCHEDULED �� :3D
PERMIT NO. ��� COMPLETED
ADDRESS �� _ � ��
OWNER CONTR. ��K P�� r l�/�-
TELEPHONE N0. g�2 ��3 q�`�Z'
� DESCRIPTION Va��-�'''� ���°�� ��-C�
� ❑ FOOTING � MECHANICAL RI ❑ EXCAV/GRADING/FILLING
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE
Q ❑ TREE REMOVAL
Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
� ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
_ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
�
W
a
�
J
O
�
�
O
�
W
�
Q
�
Z
W
�
W
�
�
C1 ,,,
W WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
� ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITNIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN ❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �95Z� Z49-46��
Owner/Contractor on si :
Inspector. �
White Copy/lnspector's File Canary CopylSite Notice