HomeMy WebLinkAbout2011-00410 - water softner CITY OF ORONO P�RMiT No.: 2oi1-oo410
' 2750 KELLEY PARKWAY
` ORONO, MN 55356- DATE IssuEn: 06/OU2011
952 249-4600 FAX: 952 249-4616
ADDRESS : 3860 CHERRY AVE
' PIN : 08-117-23-33-0008
LEGAL DESC : CRYSTAL BAY VIEW
: LOT 014 BLOCK 003
PERMIT TYPE : PLUMBING (<$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER SOFTNER
APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00
CULLIGAN SOFT WATER SERVICE CO. STATE SURCHARGE PLBG(<$500) 5.00
6030 CULLIGAN WAY
MINNETONKA, MN 55345 MAIL-IN FEE 2.00
(952)912-7379 MISC FEE 0.00
TOTAL 22.00
PA[D WITH CC# 0597
OWNER
TRUSTEES, RR ENGLUND ET AL
9700 PORTLAND AVE S#324
BLOOMINGTON, MN 55420-
AGREEMENT AND SWORN STATEMENT
Thc work for which this permit is issued shall be performed according to
the approved plans and spccifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of l80 days at any time atter work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any timc for due cause.
l/����W�(i U/v l l l l
� Applicant Permitee Signature Date Issued By Si ture '�ate
� SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBE AB E.
06/O1/2011 13:18 FAX 9529335049 CULLIGAN MNTKA �j002
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FOR CITY U5E ONLY
�,Y'�""p��� City of Orono
P,O.Box 66 Date Received: Permit�l
(��E,,,, �� 2750 Kelley Parkway
;�*�(N��,;'_��i Crystal Bay,MN 55323 Approved By: Amoun[$:
\ \�t�j�':�,�t � (952)249-4600
� ,_...�,.
CITY OF ORONO—PLUMBING PERMIT
(All Commercial permits must be approved by the 8uilding OfFcial or Inspector)
GENERAL INFORMATION
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. PBRMITS ARE NOT
VALID UNTTL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE
PERMIT CARD TS POSTEA ON THE JOS 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 invofved,a separate building permit must be
obtained
5. All work must be done in accordance with State Code reyuirements.
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 A 1
�Residential ❑Commercial(Approval Required)
�New ❑ Additional ❑Repairs ❑Replace
❑ In Accessory Structure?
*You will need arior aanroval and may need CUP.(Per Orono City Code,Chapter 78,Article IV)
Job Site/Owner Information:
Site Address: �,�b� C�t,rn, �
Owner: D��a ������ Mailing Address:
city: zip: 55364
Home Phone: �1 b 3 - 5�g' �3 5`� Alternate Phone;
Contractot Information:
G�c�r���r�yA• - Contact Person: i��!
soso cuL�i�AN waY �
A�,QII'p�1E�p �e� •�•, �5�� State Bond#:
(952) 933-7200
City: Zip: Expiration Date:
Phone: Alternate Phone: �1.Sa-9 Id-�3 I�
❑ Insurance—Current:
1
06/O1/2011 13:18 FAX 9529335049 CULLIGAN MNTKA 1�003
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G:�T�'I`iJ��$�TNG:iN�TA��;ED.: . -: '.; : �:� . �
FIXTURE BSMT l 2 OTHER FIXTURE BSMT 1 2 OTHER
TYPE FL FL TYPE FL FL
Water Closet Floor Drains
Lavatory Sewer 8jector
Bathtub Laundry Tray
Shower Washer
Kitchen 5ink Water Heater
Disposal Water Softener
Dishwasher Wet Bar
Sil{cocks Miscellaneous
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Yes,this section applies
The replacement of a Residential fixture or appfiance 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;excludine the cost of the fixture or appliance:and
3. Is improved,installed or replaced by the homeowner or licensed contractor.
Skip next section,ifthis applies; Cost ofPermit $ 15.00
State Surcharge $ 5.00
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee S
(Permit Fees Continued On Next Page)
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06/O1/2011 13:18 FAX 9529335049 CULLIGAN MNTKA C�004
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•;,-.�.�.... .. :_�PERIVIL'1'�E�;CAT':CT�I;�i:"TIQN:�.';J 10 S:QVL���$500:00':,:;:<:;.;.::;
If above does not apply;follow guidelines beiow:
1. CONTRACT PR10E * is 1.25%of contract price with a(Minimum Fee of 550.00)
x.0125$
(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$ S.QO)
3. POSTAGB&HANDLING(Only on Mail-ln Applications) $ 2.00
4. TpTAL PERMIT FEE(Add Lines 1-3 Above) $ o�o�•��
� * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the
permitted work including materials, iabor,profit,and other fixed costs. It is the amount to be charged
to the castomer for the work done. If any material, equipment, labor or instailations are fumished by
the owner, tenant or any othar 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 undar$1,OQ0,000 or$5.00—whichever is
greater. Por valuations over$1,000,000 call the Building Department at(952)249-4600 for the price.
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The undersigned hereby applies to tha 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 compfete, true and
correct.
Applicant's 5ignature: � Date: � ' �' ��
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