HomeMy WebLinkAbout2005-P08863 - water softner PERMIT
CITY�OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: p08863
Crystal Bay, Minnesota 55323 Permit Type: Fixtures
(952) 249-4600 Date Issued:
6/20/2005
SITE ADDRESS: 783 Boulder Dr Unit#
Long Lake,MN 55356
PID: 33-118-23-11-0009
DESCRIPTION:
Proposed Use: Residential
Permit Class: Plumbing
Permit Type:
Fixtures Permit Sub-type(s): Water Softner
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Pernut Fee: $ 15.00 valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 15.50
APPLICANT: Moore&Moore OWNER: Dahlstrom Development LLC
10336 299th Ave. 7745 Polaris Lane
Princeton,MN 55371 Maple Grove,MN 55311
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.
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APPLIC PE ITEE SIGNATURE IS UED BY SIGNATURE
Copies: 1-File(Signatures Reguired), 1-Applicant, 1-Monthly Reports, l-Assessing,(If Septic, 1-Septic) Page 1
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, ' FOR CITY USE ONLY
" ` City of Orono
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� \ Q.O.Box 66 Date Received: Perrnit#
��z:. �'' 2750 Kelley Parkway
1'�',. � Crystal Bay,MN 55323 Approved By: Amount�:
���o� (952)249-4600
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CITY OF ORONO—PLUMBING PERMIT
(Atl Commercial permits must be approved by the Building Official or Inspector)
GENERAL INFORMATION
1. You may apply for plumbing pemvts by mail or in person at the City offices. Applicarions will be
reviewed and a permit will be issued within two working days.
2. Pernut 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. Plumbing permits may be issued ONLY to licensed plumbing contractors and to pmperty owners
residing in the dwelling.
4. When any new construcrion or remodeling is involved,a separate building pernut must be
obtained.
5. Al(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 hoar notice required)
TYPE OF PERMIT
Check All That A 1 )
esidential ❑Commercial(Approval Required)
❑New ❑Additional ❑Repairs ❑Replace
❑ In Accessory Structure?
*You will need prior apnroval and may need C'UP.(Per Orono City Code,Chapter 78,Article N)
Job Site/Owner Information:
5ite Address: � D � �[����� ��'�
Owner: _ln I�lv� �-P/'✓��¢►�lu- �-t'j/vt�S Mailing Address: a�S� C��� /��y
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c��y: a ,���,� z�p: _�3 S'�
Home Phone: Alternate Phone: `�-�� �' ��3`�"� 7 I
Contractor Information:
Contractor: �'� � /' `��� Contact Person: �t
Address: �f'��S ' o�`���/t.� State Bond#: �9�S�g�
City: �'w�C� Zip:��37 J Expiration Date: �o� r ��'O S�
Phone: �1�, �535- 1�O Alternate Phone: `��3 '��� _D/��
❑ Insurance—Current:
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PLUMBING FIXTURES BEING INSTALLED
FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1
TYPE FL FL TYPE FL FL
Water Closet Floor Drains
Lavatory Sewer Ejector
Bathroom Laundry Tray
Shower Washer
Kitchen Sink Water Heater
Disposal Water Softener
Dishwasher Wet Bar
Sillcocks Miscellaneous
PERMIT FEE CALCULATION(S)
BASED OFF -2002 STATE STATUE
❑ Yes,this section applies
The replacement of a Residential fixture or appliance 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,instailed or replaced by the homeowner or licensed contractor.
Skip next section,if this applies; Cost of Permit $ I5.00
State Surcharge $ .50
Mail-In Fee(If Applicable) $ 1.50
Total Permit Fee $�
(Permit Fees Continued On Next Page)
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� PERMIT FEE CALCULATION(S)—JU�3S UV�K�SUU.Vu �
• - � " If above does not apply;follow guidelines below:
1. CONTRACT PRICE *is 125%of conhact price with a(Minimnm Fee of$35.00)
x.0125$
(contract p�ce) (minimum 535.00)
2. STA'I'E SURCHARGE •*Add the tate ldg Code Div.Surcharge(Minimnm Fee of 5.50)
x.0005 $
on ct price) (minimum S .50)
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3. POSTAGE&HANDLING(Only o Mail-In,�pplicarions) $ 1.50
.
4. TOTAL PERMTT FEE(Add nes 1-3 Above), $
■ * CONTRACT PRICE or JOB COS means the actual or estimated dollar amount charged for the
permitted work including materials, I ,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 installarions 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.
■ ** The STATE SURCHARGE is .0005 of the contract price under$1,000,000 or$.50—whichever is
greater. For valuations over$1,000,000 call the Building Department at(952)249-4600 for the price.
PLUMBING PERMIT APPLICATION AGREEMENT
T'he undersigned 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 statements made on this application are complete, true and
correct.
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Applicant's Signature: {` Date: 6"�7 ���
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