HomeMy WebLinkAbout2014-01188 - water softner CITY OF ORONO * 2 fd 1 4 — 0 1 1 8 8 *
2750 KELLEY PARKWAY DATE ISSUED: 10/14/2014
' • ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 1719 FAGERNESS POINT RD
PIN : 17-ll7-23-21-0005 ,✓.�� �. � /`�
LEGAL DESC : MAPLEGATE INLET �� � �
: LOT 004 BLOCK 002
PERMIT TYPE : PLUMBING (<$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER SOFTNER
NOTE: WATER SOFTENER
APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00
STATE SURCHARGE PLBG (<$500) 5.00
CULLIGAN SOFT WATER SERVICE CO. MAIL-IN FEE 2.00
6030 CULLIGAN WAY
MINNETONKA, MN 55345 TOTAL 22.00
(952)912-7379 Payment(s)
CREDIT CARD 8645 22.00
OWNER
DARLING, LAUREEN
1719 FAGERNESS PT RD
WAYZATA, MN 55391
AGREEME1vT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances goveming this type of work
shall be compied wi[h whether or not specified hereia This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any[ime for due cause.
Y��1 �,-� � !� i�� i<�
Applicant Permitee Signature Date Issued y Signature Date
10/la/2014 1�:2� F�X 9529335049 CULLIGAti' MtiTKA C�002
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���� City of Orono FOR CITY US�ONLy
/�+� Q P.O.Sox 66 Dute Recerved: Permit#
�� ti,;,�,., 2750 Y.cllcy Parkway
i1 �"�''�' L Cryslal Bay,MjJ 55323 Approvc�8y; Amount$'
11� h1 u^�';'- ;
\� ''i�ry„t'��/ (452)�49�6Q0
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CIT�.'"OF O�ZONO�PLYI'MBTNG PERMIT
(All Commerciel permi�mu;�be approved by the 8u;lding Of�icial or Inspector)
G�NLRAL IN�'ORMATION'
1. You may apply for pl�unbing permits by mail or in person at the City o�ces_ Applications will be
reviewed and a pel'mit will be issued with(n lwo working days,
2. Permit cards wila be sent by return rnai]af}er a Ceview is completed. P�RMITS ARE NOT
VALTD UNTIL YOU RECEIVE A PEl'LMIT. WORK MUST NOT BEGIN UNTrX,THE
PE}�]v�IT CARD T5�OSTED ON'I'�T�JOB SFTE.
3. Plumbing permits may be issued ONLY to licensed plumbing contractors and 1.o properry owners
residing in the dwelling_
4. When Any ncw cpnstruCtion or remodeling is involvc� a separaie buildin�permit must bt
obLained.
5. All work must be done in accordanCe with Statc Code requivements.
6. All work must be inspected and air tested before it is eovcrcd. Cal)(952)2�9-4600_
(Z4-48 hour notlCe required)
7"'YPE OP PERMIT
Check All That A 1
�Residcntial ❑Commercial (Approval Required)
�Net►' ❑Additional ❑Rcpairs ❑Replace
�� �
� In Accessory 5tructure?
*You wi�1 need rior a ro�v:�l and may need .UP.(Per Orono City Code,Chapter 78,Articlt 1V)
Job Site/Owner Infvrmation:
Site Address: t�1 a e,� vw,�g T� �
Owner: �a � �a��h Mailin�A.ddress:
Gity: Zip:
Home Phone: Alternate Phone: �.S a -y7 � -��.�C�]
Contractor Information:
Contractor: Contact Person:
�lJ��,dGAiV WAT�Fi COMDI1fIQN1NG `
Addre�330 CULLI�Ah� 1N,Q,Y SCate Bond#:
MIN�kET4NKA, MN 5�3
City: �952) g3�-�2a� zip: Expiration Date:
Phone: Alten�ate Phone: 9��-�1 a- 7_�
❑ Insurance—Current:
]
10/la/2014 13:2a FA� �5293a504� CULLIGAN MNTKA C�003
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�.�.' 'Px.Y7'MB1NG�'Z�I'T�RE'S;BEINGra7�rST�:L;LED'
FIXTUIZE BSMT 1 2 OTHER FIX'1'liR� BSMT 1' 2 OTHER
TYP� FL FL TYPE FL FL
Woler Closet Floor Drains
Lav�tory 5ewer�jector
Bathtub Laundry Tray
Sl�ower Washer
ICitChen 5in}: Water I�eater
Disposal Water Softener
Dishwasher W�g� '
Sillcocks Miscellaneous
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�A�Ty' C�
�}��0��`��I 9.,�(M � n��a h�� �� � '�r n ). �,���t�1 A����7� Y� 4 i .�$1�ti i��l ;��°�����i��Pi� �Pr4�
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! ,,� P}� 1kd.�1�� trn�h,�.i�.4, a��.Y'11D�L'�����. �VQ��,���.1'�L' J�A.��. _.��4M��1� 9�,n G Yi�,p��i"Pq���l���'�'�p��l
�'n,�YI,.. rd�.;�,.��I 1;Glrcl't .
❑ 'Yes,this section applies
1'he replacement of a Re identia]fi re or a nliance that meets aIl thrce of the following requiremen�S:
1. Docs not require modification to elechical or gas service.
2. l�las a total cost of$500,00 or less;e cludin the cost of the fixture or appliance:and
3. Is improvcd,instAlltd or replaeed by the homeowncr or licenscd contractor.
Skip next section,if this applics; Cost of Permit $ 15.00
State Surchar�e $ 5.00
Mail-In Fee(If Applicable) $ ,2.Q0
Total�'crmit Fee g
(Permit Fecs Continued On Nezt Page)
2
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10/13/2014 13:2a F�� 9529335049 CULLIGAN ViNTKA �004
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,,; tl '��x:�%���E�;�Ait�r���i�r�CS"�=:ioBs-Q���`�$�oo'.00 ,, ..,
If above does not apply;follow guidelines below:
1. CON'f�ACT PRiCF "`is 1.25°/a of contraet priCc with a(M�nimum Fee of$50.00)
x_0125$
(conffacT price) (minimum$50.D0)
2. STATE SUTtC�ARGE *�Add the 5tate Bldg Code Div. Surcharge(Minimum Fcc of�5.00)
x .0005 �
(conirRcl pricc) (Ininimum$ S,OQ)
3. PpS7'AGE&HANp�,1NG(Only on Mail-Cn Applications} $ 2.00
4. TOTAl.PER1viIT FEE(Add Lines L-3 Above) � ��. ��
■ * CO:VTRAC7 PRICE or J013 C05T mcans the actual or estimated dollar amount charged for the
permitted work including materials,labor,profit, and other fixed costs. ft is the amount to be char�ed
i0 the customer for the wprk dona If any material,cquipmen[, labor or installtltions are furnished by
the owner,tcnant or�ny other party, the reasonabie market value of sach items must be added to tJie
cstimated cost or con�raet price for permit fcc purposes. In the event that there is a dispute on the
amount of the job cost, the Ciry may request the submission oF a signed eopy of the aetuaI contract.
■ *'�The STATE SUTtC1�lARGE is.0605 ofthe contract prioe under�1,000,000 or�5.00,whichevcr is
�areater, FoC valuations ov�r F 1;000,000 caI]the Bvilding Dcpartment at(952)249-4600 for the price.
r�ll jh I,�PI����"6��� lj��� 'I�p�����3u�1'��������iJ,".Y'lr'I%`L�^Ir•,.�,��.� �15�;�' �� �9'�Y��. ��)�n��.�'1!`� `i`�� ���
1,. q�.�V '�� M( II�a,d.�W i !V� rA.i .d��'1��Y.er�
The undersigned hereb}� applies to the City for issuance of a Ptumbing permit, �,grees to do all
work in strict accordance with the ordinances of the City and the regulations of the State of
Minnesot� and certifies that al] statements made on this application are complete, true and
correct.
Applicant's Signature: Date:�- �.�- ��
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10%13%2014 1�:23 FAX fl529a35049 CtLLIGAN MNTKA C�001
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b�tt�r wat��r_ pur� c�r�d swmpl�;m
6030 Culligan Way, Minnetanka, MinnesoCa 55345
Telephone (95Z) 933-720� Fax (95Z) 933-5049
www_culliganwater.�om
At#ention: C e-r'm��TS ,� Date: / /
Company Name: �i�`� C�� �1'�`0�'1 b City & State:
Fax Number• �5a1 • r�y q ` � � � � # Pages Sent' _ _ _
� (not including c��er shee#)
From: ._
Message: y�o� o �9 0 013� � ��s---- �L� 3 s�, -
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