HomeMy WebLinkAbout2007-P11429 - vacuum breaker PERMIT
CITY JF �RONO
Permit Number:
2750 Kelley Parkway - PO Box 66 P11429
Crystal Bay, Minnesota 55323 Permit Type: Vacuum Breaker
(952) 249-4600 Date Issued: 9/11�2007
SITE ADDRESS: 4650 Creekwood Tr Unit#
Maple Plain,MN 55359
PID: 30-118-23-33-0006
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:
Vacuum Breaker for Lawn Sprinkler
FEE SUMMARY: Permit Fee: $ 15.00 valuation: $ 0.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 15.50
APPLICANT: Earl W. Day&Sons, Inc. OWNER: Kevin&Lori Bjork
P.O.Box 294 4650 Creekwood Tr
Long Lake, MN 55356 Maple Plain MN 55359
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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APPLICANT PGRMITEE SIGNATURE UED BY SIGNATliRE
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Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, I-Assessing,(If Septic, 1-Septic) Page 1
FOR CITI'USE ONLY'
,O¢��O City of Orono
P O.Boti 66 Date Received: Permit#
27>0 Kellev Parkwav
�� �i,''�!• � Crystal Bay,MN 55323 Approved By: Amount$:
� ��' v.o�/� (952)249-4600
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CITY OF ORONO—PLUMBING PERMIT
(All Commercial permits must be approved by the Building Ofticial or Inspector)
GENERAL INFORMATION
1. You may apply for plumbing permits by mail or in person at the City offices. Applications will be
reviewed and a permit will be issued within two working days.
2. Permit 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 property owners
residing in the dwelling.
4. When any new construction or remodeling is invo(ved,a separate building permit must be
obtained.
5. All 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 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 u�-ior approval and may i�eed C�t_�I'.(Per Orono City Code,Chapter 78,Article IV)
Job Site/Owner lnformation:
Site Address: 46so c�eekWooa Tra�t
Owner: B�ork Mailing Address:
Long Lake
C1�: Zlp:
Home Phone: Alternate Phone:
Contractor Information:
Earl W.Day&Sons,Inc. Diane Johnson
Contractor: Contact Person:
520 Brimhall Ave 5033PM
Address: State Bond#:
Long Lake 55356
City: Zip: Expiration Date:
P}lOrie: �y52)473-8403
Alternate Phone:
❑ Insurance—Current:
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PLUMBING FIXTURES BEING INSTALLED
FIXTURE BSMT 1 T ZND OTHER FIXTURE BSMT 1 r 2ND OTHER
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 �
�Jacuu,r�nbr�ea��e�
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,installed or replaced by the homeowner or licensed contractor.
Skip next section,if this applies; Cost of Permit $ 15.00
State Surcharge $ .50
Mail-In Fee(If Applicable) $ 1.50
Total Permit Fee $ 15.50
(Permit Fees Continued On Next Page)
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PERMIT FEE CALCULATION(S —JOBS OVER $500.00
[f above does not apply;follow guidelines below:
1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$35.00)
x .0125 $
(contract price) (minimum$35.00)
2. STATE SURCI-IARGE ** Add the State Bldg Code Div.Surcharge(Minimum Fee of�.50)
x.0005 $
(contract price) (minimum$ .50)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $
■ * CONTRACT PRICE ar JOB COST means the actual or estimated dollar amount charged for the
permitted work including materials, labor, 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 installations 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
The 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.
Applicant's Signature: Date: 9- � ( "Q�
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