HomeMy WebLinkAbout2015-01437 - water softner � CITY OF ORONO * Z 0 1 5 - 0 1 4 3 7 *
2750 KELLEY PARKWAY �AT� �SSU��: 1U09/2015
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 755 DICKEY LAKE DR
PIN : 34-118-23-22-0009
LEGAL DESC : RINGERSWOOD
: LOT 005 BLOCK 002
PERMIT TYPE : PLUMBING (<$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER SOFTENER
APPLICANT PLUMB[NG FIXTURE FEE(<$500) 15.00
STATE SURCHARGE PLBG(<$500) 1.00
CULLIGAN SOFT WATER SERVICE CO. MAIL-IN FEE 2.00
6030 CULLIGAN WAY
MINNETONKA, MN 55345- TOTAL 18.00
(952)912-7379 Payment(s)
CREDIT CARD 8645 18.00
OWNER
ESAU,TERRANCE&MARY
755 D[CKEY LAKE DR
LONG LAKE, MN 55356-
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 nuli 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 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with[he State Building Code.This permit may be �
revoked at any time for due cause. �(�����
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Applicant Permitee Signature Date Issued By Signature Date
11/06/2015 11:28 FAk 952�aa5049 CULLIGAN MNTKA C�005
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� ` FOTt CITY CJSL ONLY
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Cify of Orono �� �.
a���� P.O,Box66 bateReceived: �I-G--15 Permit# ���5�. ' � �
� �„�,�,,� 27�0 Kcllcy Parkwuy . � I k' c �.i
'�7�" Crystal Say,MN 55323 AppCoved By, ��Amount S: � ��
�`� i�,���o�� (95�)249�600
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CYT'Y OF O1�ON0,PLUMBING PERNT.TT
(All Gommercit�l penni[s must be apptoved by the Building OFfieial ar Inspecror)
GEIvERAL INFOR'vIATI4N
1. You may apply for plumbing permits by mail or in pecson at thc Ciry offices. .Applications will bo
reviewed and a permit wilt be issued within two working days.
2. Permii Cards will be sent by return mail afier a review is completed. PERMITS AR�?NOT
VALIJa U'?�1T'1L YOU RECETVE A PERMT7'. WORK MUST NOT BEGI�i ilNTIL THE
P�I2l►KIT CARD IS P457"�D ON THE JOB SITE.
3. Plumbing pem7its may be i5sued ONLY to lieensed plumbing contractors and to properry owners
residino in the dwelling.
4. When any new construction or remodeling is involvcd,a separate building pe�mit must bc
obtaincd.
5. All work must be don�in acoordance��vith SSate Code requirtments.
6. All work must be inspeCied and air tested bef�re it is co�ered. Ca11 (952)249-4600.
(24-48 hour noticerequired)
T'k"PE �F PERMYT
Check All That A 1
�Residential ❑Commercia](Appt'oval Required)
�Ncw ❑Additional ❑I�epairs ❑Replace
[] In Accessory Structure?
�You wiil need arior anoroval and may n�td CUP.{Per Orono City Code,Chaptcr 78,Article IV)
Job Site/Qwner Information:
Site Address: . ��i� D►c.� ,. LA I�- 'J ►�
Owner: Y��.k�5 Q k __ NZailing Address:
City: Zip: �S S�
Home phone: Alternate Phone: , �.5� � y S�.�y�-S�
Contractor Information:
Cc�t�,a���A,�l ����� L�����«�'NG Contact Person.
6�3� c 'MN 55345
Addres�lli4�N���N�A� State Bond#:
t9 f - �
C�ty� Zip: �xpiration Date;
�'hone: Alternate phone: �5a1- q� o�- ����
❑ Insurance—Current:
1
1L06/2015 11:28 FAX 952��35049 CULLIGAN MNTKA �006
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FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 � Z OT�ER
TYPE FL FL TYPE FL FL
Water Closct Floor Drains
Lavaiory Sewer Ejector
Bt�thtub Laundry 7"ray
Shower W asher
� Kitchen Sink Water Heater
Disposal Watcr Softener �
Dishwashcr j Wet Bar '
Sillcocks Miscellaneous
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,,.,��_�;;'I�;"':',.�;v ,' �'+ '��:�, � '� ..��'SED O�'F' „200?.,�TA�TE'S'Z'���TC7� �"' '� "` �'+;;, ,, � �",;
, Yes,this section applics
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The rcplacement of a Residential fik�ture or apvliance that meets all fliree of l'he follqwing requirements:
1, Does not require modi�ication ta electrieal or g�service.
2. Has a tot c st o�'$500_00 or less;exclu 'n the cost of the fix[ure or appliance-and
3. Is improved,installed or rtplaeed by the homeownor or licensed contractor_
Skip next section,if this a�pIies; Cost of Permif � � _1S�
5tate 5urcharge $ 5_00
Mail-In Fee(If Applic�ble) $ 2.00
Tota1 Permit Fee S
(Permit�'ees Continued On Next Page)
2
11/0�/2015 11:28 FAX 9529�35049 CULLIGAN MNTKA 1�00i
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� I�abo�ve does not appiy;follow guidelines below: , �
]- CONTRAC�'X'RTC� * is 1.25%of contract price with a(1Vlinimum Fce of$50.a0)
x.012�$
(can�act pfiCe) (minimum$50.00)
2. STA�'�SCIItC�TARGE '�*Add rhe State Bldg Code Drv.Surcharge(Mfiaim�m Fee or�5.00)
x.000� $
(con�rac�pricc) (minimu;r,� 5.00)
3. POSTAGE&HANDLING(Only on Mai1-]n Applications) $ 2.00
4. TO'C'AL.PERMIT FEE(Add Lines 1-3 Above) � ��,��
■ * CONTRACT PRIC� or JOB COST means the actual or estimated dollar amount char�ed for the
permi�ted work including matcrials, labor,profit,and other fixed costs. It is the amount to be charged
to the eustomer for the work done, Cf any material, equipment, labor or installations are fumished by
the owner,tenant or any other party, thc rc�SonElble market value of such items must be added to the
estimated cosY or contract price for permit fee purposes. In She event that therc is a dispute on the
an�ount of the job cost the City may reques�the submission of a signed copy of the actual contract.
■ **The STATE SURCHARG�is.0005 of the Contract price undcr�1,000,000 or$5.00--��hichever is
greater_ For valuations over$1,000,000 eFi11 the�uilding Dcpartment at(952)249-4600 foC ihe pzice_
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'I't�e undersigned hereby appIies to the City for issuance of a Plumbing Permit, agrees to do aIl
work in strict accordance with the ordinances of the City and the regulations of the State of
Minnesota, and certifies that aIl statements made on this application are complete, true and
correct.
A licant's Signature: � Date: � �� b- �
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DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED � � /� _g .¢m
PERMIT NO. Z�:�5 -(�I V.3�OMPLETED
ADDRESS �� "�J �J l C /C_..� � f L ��- l�C�
OWNER TELEPHON O.
CONTRACTOR «- � �� S�t�'
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� DESCRIPTION `' ��� / �� �' �� � ��,/
lL ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
O ❑ 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 lB�INAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
i ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
EJNOr ITE ❑ IC INSTALL
OWNERf iiACTOR TO MEET YOU• YES_NO
v� OMMENTS:
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W ❑WORKSATISFACTORY:PROCEED ❑ PROJECT COMPLEfE
� ❑CORRECT WORK�PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
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� ❑CORRECTVIfORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WFLL REfURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
`�ECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call forthe next inspection 24 hours in advance. (952) 249-4f1�0
OwnerlContractor on site:
Inspector. �j`'��
White Copyflnspector's File Canary CopylSite Notice
a►� nMe '�
qTY OF ORONO cu�n iN
N�ISP6CTION NOTICE sc�u�n
PERM�i'NO..�v�CS- Di5�37 co� y -iv •/7
�oonFss 7�5- D.��� ��.�� .o,�.
ONMNEA TELEPHONE NO.
CONTRACrOR �
� DE$CRIPTION LYa��r 6���iTes.� s r!s�i�/
ty � FOOTIN(i � DEMO-FINAL ❑ SEPTIC FlNAL
e 0 POUpEQ WALL ❑PLUMBIN(3 RI ❑ EXCAWCiHADINOIFILLIN(i
Q ❑FOUNDATION WA'TERPHOOF ❑ PLUMBINO FINAL ❑TREE REMOVAL
Z Q RADON SLAB ❑MECHANICAL RI ❑SfTE INSPECTION
� Q FRAMINCi O MECHANICAL FINAL O RATED WALLS
� Q�TION �WOOD BURNERIFlREPLACE �(�MPLAINT
�WATER FI001C-UP �FOLLOW-UP
W ❑AS BUILT-SURVEY ❑SEWER HOOK-UP 0 FOUNDA'TWWREMOVAL
_ � DEMO-SITE �SEPTIC INSTALL
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j Permit has expired per MN Building Code Sec. 1300.120 subp. 11
� Expiration, no record of a Final inspection.
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W ❑WOFMC 8A71BFACl�OtiY:PRO(�� D PROJECT COMPLETE
� ❑OORRECT WOt1K i PROCEED ❑ISSUE C6R1F1CATE OF OOGJPYINCY
o O OOR�CT WOf�(.CALL FOR REINSPECTION T6iAPORAii1/
� �� PBiMANBdT
O()ORRECT UNSAFE OONDITION W(iHIN HOURS. ❑PHOTO TAKEN
MISPECTOR YVILL RETt1RN
❑STOP Of�ER P'08Tm.GALL N�SPECTOR ❑qTATION�BI�D
o n�ecnoN aeou�e.ci►u To�c��ccess.
cw Io�u�e n�t r�specuo�z+no�.:h aav.�oe. (952� 249-4600
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