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� CITY OF ORONO * z pJ 1 5 - 0 1 5 1 0 *
2750 KELLEY PARKWAY DATE ISSUED: 11/30/2015
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2450 COBBLESTONE CT
PIN : 33-118-23-I1-0082
LEGAL DESC : STONEBAY SIXTH ADDITION
: LOT 004 BLOCK 001
PERMIT TYPE : PLUMBING(<$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER SOFTENER
NO"I'F,: NEW WATER SOFTNF.R
APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00
STATE SURCHARGE PLBG(<$500) 1.00
WATER DOCTORS MAIL-[N FEE 2.00
8201 CENTRAL AVENUE
SPRING LAKE PARK, MN 55432- TOTAL 18.00
(763)535-1800 Payment(s)
Minnesota State License#: mech-WC645002 CREDIT CARD 8313 18.00
OWNER
Wooddale Builders
6117 BLUE CIRCLE DR
SUITE 101
M[NNETONKA, MN 55343-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if cons[ruction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time aRer work has commenced.
The applicant is responsible for assuring aIl required inspections are
requested in conformance with the 5tate Building Code.This permit may be
revoked at any time for due cause. ��
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Applicant Permitee Si nature Date Issued By Signature Date
Nov 27 1�09:41 a Water poctors 7635351805 p.1
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FOR CITY USE ONLY i
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� P_O.Eos 56 �� Date Received: �� �5 Permit� �/J
/ 2750 Kcll�y Parkxay � � �
f `i Cn�stal Bxy,��55323 i Approved By: �� Amount$: f� ��
� (952)249-�1600-:Nsin _�
I,f � i/ (952)249-4616—Fax
� � CITY OF 0�20I�10—PLLII�IBING PERMIT
y���'�f.s�+0�`� (.411 Commercial Per:nits 11ust be Approved by the State Pricr to City ApprO��al}
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G�N�RAL INFORIVIATION
1, You ma}� apply for plumbing pennits by mai!or in person at the Cicr o`f ces. Applicatious will be
revie���ed aiid a permit will be issued within two wurking days.
2. Permit cards will be sent by a•eturn mail after a review is completed. PERIvIITS ARE NOT
VALID UNTIL YQU RECEIVE A?ER'�IIT, bYORK MUST tiOT BECIN UNT1L THE
PEKMIT CARD IS POSTED ON THE JOB SITE.
3. Y;umbing permits may be:ssued ONLY to Iicensed plumbing contractors and fo property owners
residing in the dwclling.
4. �Vhen any new•construction or remodeling is invo(ved,a separata bui[ding pennit must be
obtained.
�. all work must be done in accordance�+�it:�State Code rec�uirements.
6. All work must be inspected and air tested before it is covered. Call(952}2d9-4600.
(2a-481�our notice required)
TY�E OF PERMIT �
(Check All That Apply) j
fl Residentiat ❑Commercial(Approval Required}
� herr ❑Additional ❑ Repairs ❑ Replace
❑ [n Accessor} Structure°
*You will need prior approval and r.�ay neec CUP.(Per Orono City Cod�,Chapter?8,�.r[icle[Vl
Job Site/�cvner Information:
Site Address: �`!S� �'� b���sfo r�L �-���;�
O�vner: t,Uc,r��dcz jc �v.jr.�r�ys Mailing Address:
City: Zip:
Home Phone: Alternate Phone:
Contractor Tnformation: i
Cont��actor: (�%��,-� ���c��= Contact Person: i�-�i� �r�� ��''
Address: �'�J/ 1�G_�� State Bond #_ fiv�� ��S`t�.�C
City: S%� ' ��,c�Zip:��-y,si Expiration Date:
Phone: �l�3--5'�s=t�s.�C� Alt�rnate Phone: ?1�.�.��'�-75��
❑ Insurance—Current:
1
Nov 27 i'5 09:42a Water poctors 7635351805 p.2
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FIYT[;RE BStiIT I T 2"n '� OTHER FIXTURE BSh'1T 15 2"D OTNF;R
iTYPE FL FL I TYPE � FL FL
' 1�Vater Closet � � I i�loor Drains � I
, La��atory i Seti�"r Ej ector i
Batiucb I � � Laundry"Cr2y j �
Shower i � «'asher
— — �—
I�itchen Sink � , 1Vater Heater
Disposal � � Water Softener
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pisfivasher i �� � Wet Bar
Sillcocks Miscellaneous
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� Yes,this section app:ies
The replaccment of only one Residential fixture or a liance that meets all d�ree o:the follawing
reqtirerr.en[s:
1. Does not require modification to elecErica]or gas service.
2. Has a total cost of��OD.OU or less;excludine the cast of the fixture or appliance: and
3. [s improved, i�s�alled or~eplaced�y the homeowner or licensed plumbing contrac±ar.
Skip next section;ifthis applies; Cost ofPer.nit $ I�.OD
State Surchargc $ 1.00
Mai]-In Fee(IY Applicable) $ 2.Oo
Total Permit Fce $ /$�c�
(Permit Fees Continued On 1'ext Page)
2
Nov 27 15 09:42a Water poctors 7635351805 p.3
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If a�ove�'oes not app'.y; fello�v guide�ines belo�v:
L CONTRACT PRICE * is l?S%of contract price with a(Minimum Fee of�50.00)
xA125$
(contract price) (minimum 550.00)
2. STATE SURCHARGE
x.06�� $
(con�act price)
3. POSTAGE�,H.41vULNG{Only on Mail-In Applic�tionsl $ 2.00
4. TOTAL PERl�1IT FEE{.Add Lines 1-3 Above) $
� * COtv`TR.�Cf YR:CE or JOB COST means the actual or estimated dollar amount charged kbr the
pern�itted w�ork inc;uding materia(s, labor,profit,ar.d other fxed costs. It is tha amount ro be charged
to the customer for the work done. Tf any material, equi�men�, labor or installaCions are furnished by
the orvner, tenant or any other party, the reasonable market value oE such items must be added to the
estimated cost or contract pr;ce for permit fee purposes. In t�e e��ent lhat there is a dis�ute on lhe
anount of thz�ob cost, the City ir.ay request the submissior. of a signed copy of the actual contract.
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The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do all
�aork in strict accordance ��ith the ordinances of the City and the regulations of the State of
Minnesota, and certifies that all sta`.ements made on this application are completc, truc and
correct.
Applicant's Signature:� � � �_ Date: %/ 2 7 ��
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"—��, DATE TIME /
CITY OF ORONO CALLED IN a ,�
INSPECTION NOTICE `���� scHEou�eo . � ' .��-�
PERMIT NO- �{L S � COMPLEfED
ADDRESS �-�{"��j�� C_;��.;_s�SE�:-�
OWNER TELEPHONE NO.(s i�'�' � �`-'���
CONTRACTOR ���=` ���`-�-'�- ����+�
� DESCRIPTION ��� �'r�"��-
ly ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
y ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
Z
J ❑ DEMO-SITE ❑ SEPTIC INSTALL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W O WORKSATISFACTORY:PROCEED ROJECTCOMPLEfE
� ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
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� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDiT10N WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cail for the next inspection 24 hours in advance. (g52) 249-46��
OwnerfContractor on site:
Inspector. �
White Copyl nspector's File Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION N�TICE �� SCHEDULED �
PERMIT NO. o ��` � 0�"���COMPLETED �
ADDRESS .��.�b C�h6l��.�e r d- .
OWNER TELEPHONE NO.
CONTRACTOR ��E1 e � ���6�S
� DESCRIPTION ���C� Sd'�''�''►�'�
ly ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
Z
J ❑ DEMO-SITE ❑ SEPTIC INSTALL
2 OWNERICONTRACTOR TO MEET YOU:_YES_NO
y COMMENTS:
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W ❑WORKSATISFACTORY:PROCEED ❑ PROJECT COMPLETE
� �.►s�E�T VYORK S PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
� O CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. O PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDEH POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cail for the next inspection 24 hours in advance. (g52) 249-460�
OwnerlCorttractor on site:
Inspector.
White Copyflnspector's Ffle Canary Copy/Sfte Notice