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Home My WebLink About2016-00444 - backflow device e CITY OF ORONO * Z 0 1 6 - 0 0 4 4 4 * 2750 KELLEY PARKWAY DATE ISSUED: OS/03/2016 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 1926 FAGERNESS POINT RD P[lY : 17-117-23-23-0016 LEGAL DESC : FAGERNESS : LOT 027 BLOCK 000 PERMIT TYPE : SPRINKLER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : LAWN SPRINKLER ACTIVITY : BACKFLOW DEVICE NOTE: MAKE:ZURN MODEL: 720A APPLICANT SPRINKLERS 50.00 STATE SURCHARGE FLAT-OTHER 1.00 SAMS LAWN CARE, INC. TOTAL 51.00 P.O. BOX 848 WAYZATA,MN 55391- Payment(s) (612)366-9273 CHECK 7112 51.00 OWNER VEGDAHL, KURT 1926 FAGERNESS PT RD WAYZATA, MN 55391- 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 rela[ed 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 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 afrer 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 time for d ause. I�� C/ V �� Applicant Permitee Signature Date Issued ignature Date t j`��"�� City of Orono ,1� FOR C,I'�"YI�,7C ONLY ' � �a `., P.O.Box 66 DI Date Received: `'"�J L�"r�� ', t `� 2750 Kelley Parkway �/ � f�• ti Crystal Bay,MN 55323 [�' Permit# Z C � ,, �;l;; Phone:(952)249-4600 Approved By: � a,�-E'�a�; Fax: (952)249-4616 -- Amount$: CITY OF ORONO - IRRIGATION PERMIT PERMIT CODES: City of Orono, Minnesota State Plumbing Code Sprinkler/Residential/Lawn Sprinkler/Blank Sprinkler/Residential/Backflow Device Only/Blank Please Check One: New Addition ❑ Job Site Address: � C.�� ( T t� Owner. u�� e U Telephone Number: � ' ��' `�y (�' t Mailing Address: —l�� 1 C,(' ll� �J� t� � /J� c�cy: �1I��1��- z�p: SS3�/ Sprinkler Contractor:� ��'✓� � � Telephone Number �'�O�' Y�O �2o d Contact Person: �N v�1 c� �'" License��l(1�0�� Mailing Address c � VC� � � �'./-Y.IY-� � l WATER SUPPLY: Lake ❑ Well ❑ City�. BACKFLOW DEVICE: �9�� PVB� _ Make�v�� Model� Year of Manufactur�o�� Quantity � INSTRUCTIONS Complete all items on this application. incomplete applications will not be processed. If you have questions, call (952) 249-4600. You will be notified by phone when the permit review is complete. GENERAL INFORMATION 1. You may apply for Irrigation System permits by mail (P.O. Box 66, Crystal Bay, MN 55323) or in person at the City offices (2750 Kelley Parkway). Submit plans for review with this application. 2. 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 City and State Building Code requirements. Page 1 City of Orono Irrigation Permit, Continued 5. Two(2) sets of working plans shall be submitted for approval to the authority having jurisdiction before any equipment is installed or remodeled. Deviation from approved plans will require permission of the authority having jurisdiction. Workinq plans shall be drawn to an indicated scale on sheets of uniform size with a plan of the site so that they can easily be duplicated and shall show the following data: a. Name of owner and occupant b. Location, including street address c. Point of compass d. Location of septic system if applicable e. Source of water supply f. Pipe size g. Pipe location h. All control valves, check valves, drainpipes i. Name and address of contractor 6. All work must be inspected (final). Call (952)249-4600. 24 to 48 Hour Notice Required PERMIT FEE CALCULATION 1. Permit Fee: $ 50.00 2. State Surcharge � �.-oo �-�� 3. Mail-In Fee �$_._�99----- ��` � 4. TOTAL PERMIT FEE (Add lines 1-3 above) $ The undersigned hereby applies to the City of issuance of an Irrigation System Permit, agrees to do all work in strict accordance with the ordinances of the City and State regulations, and certifies that all statements made on this application are complete, true and correct. Applicant: ' Date: �� 0�� Approved� A ved with Corrections: Denied: Reviewed By: ` Date: l �� ` Page 2 ra S �. �, �_ � �r, � yf �' �� / � �J P . 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'�```H� -- _______ ----- •�� ' � �,L0 / �y .___.r � ` / � � � t .: O x ,/ /� /`'u �� 1� / � ` .i4' •��o // �� .q Sat t f Z �n Ir�, P;pe - ' f /�/ '� '9l `1•' «�lh RlS 96�0 D�stic cop ; �/ b '1.`� (.nnit :6�%�.z.,i+ �a,! !0,:{:� !/ �'�c�� ,. / `\L I�, ��V / �� 'y�,r'�� `W �►r � PV'B backflow device j�°� to be installed by plumber � � under seperate pernlit, 1" o Supply . . , ,, �...,. .. ., ...� .�.�,� , Il��' ,��;.,. 1926 Fagerness Pt Road �� DATE TIME CITY OF ORONO CALLED IN INSPECTIOA�N,OTIC��`� SCHEDULED 2 ��rJ ��.� PERMIT NO��i% � COMPLETED ADDRESS ��{ ZP�� C��(�'f'��J P�I�� OWNER TELEPHONE NO.�� oC2- Z�v7— CONTRACTOR �f"�� ( (�-1 C t� � �'S� � DESCRIPTION ��i�r`�'��='`'' c�n�l ty ❑ FOOTING ❑ DEM -FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ MBING RI ❑ EXCAV/GRADING/FILLING y ❑ 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 ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL _ J ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 OWNERICONTRACTOR TO MEET YOU:_YES_NO c�., COMMENTS: � W a 2 � O � � O � W � Q � 2 W � W � j d W ❑WORKSATISFACTORY:PROCEED PROJECT COMPLEfE � ❑CORRECT WORK 8 PROCEED SSUE CERTIFICATE OF OCCUPANCY W � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN INSPECTOR WILL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. 249-46QQ OwnerfContractor on site: Inspector. White Copyllnspector's Ffle Canary CopylSite Notice