The URL can be used to link to this page

Home My WebLink About1984-7579 - new well GENERAL PERIVIIT CITYPERMITNO. -f �5"�9 � CITY OF ORONO Dat� ,�=� � - r r.o.aox 66 � CRYSTAL BAY, MINNESOTA 55323 (612) 473-7357 1 /, 1 Owner � 1�-'�i��--- Address � l/ t-k�'�JC V 1 � � Contractor � � Address �� // GU(/ ��S - ��/�`C� �� City License No. �•��' State License No. RF�,MARKS AND SYECIAL CONDITIONS PERMIT TYPE AND FEE: W ❑ ADDITION ❑ REPAIR Inside Plumbing ( # fixtures ) Fee $ On Site Septic System F�e $ Water Meter(Size ) Fee $ Water Well Fee $��.��lJ Meter # Mechanical Equipment Fee $ Remote# Municipal Water Connection Fee $ Moving/Lifting Buildings Fee $ ❑Copper ❑ Land Alteration (Excavation, Fee $ Grading, Filling, etc.) Municipal Sewer Connection Fee $ ❑ PVC ❑ Cast n Other: Fee $ MWCC SAC Charge Fee $ After-the-fact Investigation Fee $ ACKNOWLEDGEMENT TOTAL The undersigned hereby acknowledges receipt of this limited permit, including acceptance of all special information, �� terms, conditions or requirements written above. The undersigned understands and a�ees under penalty of law State SUI'Clldi�e: Fee $ ' that this permit is strictly limited in scope to the work, activity or improvement specified; that this permit does i. � not grant any authority to do work or activities requiring Total Amount Paid to City Fee $ sepazate permit approvals; and that this permit does not �ant authority to violate any provision of any City ordinance or State law,rule or regulation. All work shall be done in strict compliance with all City ordinances, building codes and/or health department regulations, and stiall be This permit is not valid until the proper fee 1S pa1C� 3I1C� subiect to inspection, approval or reiection by the c�cy. it is approved by an authorized City Official. Whenever so ordered, the undersigned agrees to correct any work found to be in violation of the conditions of this permit. Signature of Applicant Sig u e of City Official �� ' ,; �l ��r � -�� Code:White—Pile Copy Canary—Inspectur's Copy Pink—Finance Copy Gold—Applicant's Receipt ' ;l � �� <'` �,�-i � , ;:.� �",� ' I;� � / � _ `' �/�� f' J/ ,I _I • �. . � � . � � , ` � � . . � .. �, � CITY OF ORONO y _..,�� :/ ti� APPLICATION FOR MECSANICl�L PERMIT � GENERAL INFORMATION . 1. You may apply for mechanical permits by mail or in person at th� City offices. Mailed-in permits are subject to the postage and handling � fees shown below. � . 2. .. Permit cards will be sent by return mail the same day the application is received. PERMITS ARE NOT VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS POSTED ON THE JOB SITE. 3. � When any new construction or remodeling is involved, a separate building permit must be obtained. 4. All work must be done in accordance with State Buildinq Code � requirements. . . 5. All work must be inspected (rough-in and final). Cal 1 473-7357. 24- hour notice required. , 6. House Heating Test Record must be submitted before final. INSTROCTIONS Complete all items on this application. Compute the permit fee. Sign and date the certification. INCOMPLET� APPLICATIONS WILL NOT BE PftOCESSED. If you have questions, call 473-7357. WALK-IN PERMITS apply at City Offices, 1335 South Brown Road (Cty. Rd 146) " MAIL-IN PERMITS enclose fee - Mail to: P.O. Box 66, Crystal Bay, MN 55323 **#f*****�*t*****��,t�f***�****�******************************************** JOB SITE � � ' Owner's Name �, � Telephone Number - < Mailing Address � �� ' � �� r�� c�)L� 5 - 'S� Contractor's Name � - �� - •% Te� phone Number - �c� Mailing Address �� d �� r � � �� L- l�, P ��rt� SS -�� tt*�**,rf***+tr**�**�****�******* ***�**********�*****************#*f*******# MINIMUM FEE ($25.00 per project) ***f***�*t**f****�*tf***t***************�*************#********�*********** HEATING SYSTEMS � $20.00 each unit , , , ,<. F�I+ � nat'. gas, lp gas, oil, elect. otheri (specify if combination burner) . EQUIP. (if more than 1 unit per bldg. list each separately) N0. TYPE BTUH IMPUT BRAND 'NAME MODEL N0. _� f.a. furnace L;. �� ; _a�-t�iCr ` ; '. � hw boiler � unit heater solar htg. equipment � _; Solar Equipment $50.00 each system Tot-� =�C% � �' **�+r***�*rr*�*��***#�r�*****************************************************� S�:�Z` AIR CONDITIONING $20. 00 each unit Central Air Separate Central Air Sy,�tem , w/f urnace Brand name Model No. Tons Total ********f***f***********************************************�************** *WOOD BORNING EQUIPI�NT $30. 00 each unit Wood stove with flue . , ., � � � $30. 00 each unit Wood combination or add-on unit �-� � ' •- K � $30. 00 each unit Factory f ireplace with f lue Factor Fireplace (s� freestanding built-in Wood Stove (s) franklin, other �� Brand Name - " Mode 1 No. ' °Mfqr's Min. , Clearances, 'side , rear , min. flue dia. _ . Total �*�ra�*�r��*,��re�*ter*****��er***��rr****�*�,**t�*******�,r**,�rr�r*,�*,r****rr*****�r,��* ' � VENTILATION � � $5. 00 each exhaust fans, (bath, kitchen, attic, etc. ) , No. Kitchen Exhaust ducted recirculating �,o cfm �� No.� " Bath Exhaust (must be ducted outside) tio cfm ,�' No. Other Fans: Locations cfm � Total - *******,r*****�**************�********************************************** FUEL STORAGE (must be approved by fire marshal ) $20.00 Permanent . $10.00 Temporary Fuel oi'1,� � gallons underground inside outside � LP Gas, gallons ' � Other ' '- ***+r�r,rt#**t#�*�r***�*********************************************�********** �SPRINRLER SYSTEMS , Minimum $20. 00 each system Number of Heads No. of Risers $2. 00 per head . . : .*,�*�#********************�***********«*rr********,r***********�*******,r****** � G�S LINB ZNSPECTIOI�i ';' High%Low Pressure � $30. 00 � ... *#ttkt+kt*�*,tf,t#tt*,t,tfe*************************************rttr**************** . -. . ' . . PERMIT FEE CALCOLATION - - 1. Total of above Installations or Minimum Fee ( $25. 00 ) $ �C.� �� ._ . 2. State Surcharge. Add the State Building Code Division Su+ch�rge to ea�h permit $ . 50 � � � ' �' 3. " � Posta�e and Handling on all mailed-in applications, �-1. 50 4• y �QTAJ�,��RM�T ,F�E add lines 1-3 above $'�� The undersigned hereby applies to the City of issuance of a Mech�nical Permit, agrees to do all work in strict accordance with the ordinances of the City and the regulations of the Minnesota State Building Code, and certifies that a�.l statements made on this applic 'on e �omplete, true and correct. � ' ` ' // /� - ' / / ' C / . . . .. ...,t / / ,� , ' .y.� ., ..._ . .. . � / / � ,/ � � ��--� - - �-Applicant � � � �z Date ��" � "� ... .. .. Y• �e,. . . . � u A�. N..'' ., r� M . .. . .. . . . � ' � ' • [ �E� TIME CITY OF ORONO cA��Eo-iN � INSPECTION NOTICE SCHEDULED � P E R M I T N O. c nn P�E T E� �:�---i`—�'--r_'y -1�—: 2..(�� ADDRESS T � • L�• OWNER CONTR. TELEPHONE NO. ❑ FOOTING ❑ PLUMBING RI ❑ SITE INSPECTION ❑ FRAMING ❑ MECHANICA� ❑ EXCAV./GRADING/FILLING � ❑ INSULATION ❑ WATER HOOKUP ❑ LAKESHORE/WETLANDS � ❑ WALL BD. ❑ METER SET/TURN ON ❑ LICENSING lL ❑ FINAL ❑ SEWER HOOKUP ❑ COMPLAWT �L ❑ PROGRESS ❑ SEPTIC INSTALL. ❑ FOLLOW UP � ❑ DEMOL. SEPTIC MAINT. ❑ SEPTIC FINAL Q ❑ FIRE PREV. &WELL TEST PUM`�� FIREPLACE/WOOD BURNER Z � Q COMMENTS: � �,�� c� � � J Q �U Z J Q ° ,5�i x��SG�'� �'�/� �'C'��:�� 01v � � w � � J � �� ' �'�'�'� _ 0 � 4i <<_ �,� 0 —�-y_. (�e � � ; �:l�__ �.., � Q � z w � w � � a w � W �ORK SATISFACTORY: PROCEED ❑PHOTO TAKEN O �❑ CORRECT WORK& PROCEED V ❑ CORRECT WORK. CALL FOR REINSPECTION BEFORE COVERING p CORRECT UNSAFE COND�TION WITHIN HOURS. INSPECTOR WILL RETURN. ❑ STOP ORDER POSTED. CALL INSPECTOR. ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. call for the next inspectio 4 hours in advance. / Owner/Contr. on site � Inspector � / 473-7357 White Copy/Inspector's File Gold Copy/Site Notice