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Home My WebLink About2005-P08472 - plumbing CIT'�' OF ORONO PERMIT �` Permit Number: 2750 Kelley Parkway - PO Box 66 Posa�2 Crystal Bay, Minnesota 55323 Permit Type: FiX�ures (952) 249-4600 Date Issued: 2i2si2oos SITE ADDRESS: 3075 Farview La I.ong Lake,MN 55356 PID: 04-117-23-33-0006 DESCRI PTION: Proposed Use: Kesidential Permit Class: Plumbing Pernzit Type: Fixtures Permit Sub-type(s): Multiple Fixtures DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: � 100.00 Valuation: $ 8,000.00 State Surcharge Fee: $ 4.00 TOTAL FEE: $ 104.00 APPLICANT: Mark McCollum(See Comments) OWNER: Martin&Kimberly Lymn 15136 74th Avenue N 3075 Farview La Maple Grove,MN 55311 Long Lake MN 55356 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED AND AGREES TO DO ALL WORK IN STRICI'COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. �2� � ��;t. ' C7YY\ C.,fin �� APP ICA T PERMITEE SIGNATURE ISSUED SIGNATURE Copies: 1-File(SiQnitures Required). 1-Avplicant, 1-Monthlv Revorts, 1-Assessing, 1-Finance Page 1 Feb-16-2�05 09:37am From-CITY OF ORONO +9522494616 T-597 P.004/005 F-410 s �Y��y p� p�pNp APPL�CATYON FOR PI.,UMBING PE�tMIT Box 66 (2750 Ke1ley Farkwa�) Crystal Say, 1VIN 553�3 G NERAL Tr�O MATION 1. You may apply for piumbing permits by mail or in person at[he Ciry offices. 2. P�rmit cards vvill be sent by return mail after a review is campleted. PERMYTS ARE NaT VAI.ID UI�TIL YOU RECEIV�A 1'ERIVII'T. WORT�M'(JS.T NOT B�GTN NTIL THE F�I2MT7'C,4RT�TS POSTED ON THE JO� SJTE. 3. �lumbing permits may be issued�NLY to licensed plu�bing contractars and ta properry owners residi�lg ui rhe dwelling. 4_ Wb,en any new construcdon or remadeling is involved, a separate buildi.ng Qermit must be obtained_ 5. All work must be done in accordanCC wirll rhe State Code requ'rrements. 6. All work must be inspEcted and air tested before it is covered. Ca11 (952j 249-4600. 24-hour notice required. Yns#r�►ctions Complete alI items on this applieation. Compute the penruC fee. Sign and date the certification. YNCQIvIPLETE APFLYCATI4NS WYLL NOT BE PROCESSED. If �'ou have q�es�ions, cal� (952) 249-4600. Please check one; �Iew �Addition Repair �Replace Residenti.al Commercial �os s��:3 0 7.� � r-t/� �,,� Ja r�c. �z��: Qwner's Name• _ Telephone Number• _ __ Maxling Address: _ City: Zips C�ntractor's Name•�'�1�!'� �yl�Lo/u� _ Telephone Number:763 -y6� �2�3 11�ailing Address: T� dc City:��/e �Cbv�Zip�s�.S��/l -- PLUMBYNC FI�URE HEDUL� �IXTURE BSMT 1ST 2ND OTHER FIXTUR,E BSMT lST 2NY7 �TH�R TYP� FL FL TY"pE FL FL Wa[er Closet � Floor 1?rains Lavato � Sewer �'ector �a�� Laund Tra Shower Washer TGitchen Sink � WaFer Heater Ais osal Vlrflier Softener Dishwasher � Wet�ar Sillcacks Misc{list) Feb-16-2005 09:37am From-CITY OF ORONO +9522494616 T-597 P.005/005 F-41� , a ' PERMT'�' FE� CALC�JL, 1T�I4N(S� 2002 St��t� e � Y'es, This Section Applies The replacement of a Residen ial fixture r a lianc that meets all Chree of the following requirements: 1) �oes not require modification to electrical or gas service. 2) �Tas a total G� of$500.04 or less; excludin� the cost of the fixture or appliance: and 3) Is impro�ved, installed or replaced by the horr�owner or licenced contractaX. Ski� ne�c� section; CosC of Permii $ 1�.OQ _ State Surcharge $ .SO Mail In Fee $ 1_50 Tf above does not apply, follow guidelines below: 1. Con ract Price* is .4125 % of job wich a Mi imum Fee_�L$3S._� /O O. �� 00• �a X .012S $ .� (conkr�ct price} (rninimum$35.Qb} 2. Sta�urc��e. ** Add the State Buildi� Gad� Divisio� a (Minimum Fee of$ .50) $000. �� x .000s � y• � -- (contract gricc) (minimum$ .50) 3. �'o�ta�e and Handlin� (Qniy mail-in applicatians) $ 1.50 ._ . ��t�(, co �. T�TA.L PEY2MIT FEE (Add lines 1-3 above) $ _— * Cpi�TRACT�12ICE ar�OB C�ST means the actua�or estimated dollar arnonn�charged for the permitted work including materials,labor,pro�`it,and other fix�d costs. It is the amount to be charged ta the cus�omer for the work done. Yf any material, equipmenti, labor, or installatian are furnished by th�o�vner, ten�nt or any other ga�ty the reasonable market v�lue of such items mu�t be added to the estimated c4st or contrac� price for permit fee purposes. Xn the event that there is a dispute on the amounti of the job cost, Che Ciry may reques�the subrnission of a signed eopy of the aecual conuact. ** '�'he STR,TE 5'URCHARG�is .0005 of the contracti price einder$1,OOO,qpo or $.50-whichaver is greaur. For valua[ions ovc�$1,OOO,QOQ ca11 the Department of Inspection Serviccs for the price. The undersi�ned her�by appkie5 to the City for issua.nce of a P�umbing Pe��, agrees to da alI worl� in strict accordance with the ordinances of ik�e Ciry and the regulations o�' the State of Minnesorta, and cea�ti��s xhat all statements rnade on this application are complete, crue and correct. Applicant's Signature:�„ �e;�K ��Z�-`" Date`��'�� Feb-16-2005 �9:36am From-CITY OF ORONO +9522494616 T-597 P.003/005 F-410 Scc.13.44 RIGEi"Y'S OF SL�.�CTS OF DA'CA, Sabd. 1• Type af data. Zhe rights of i�div�dua!oo who�the dztx is stor�d ot m bc stnred shs11 bc�s sec forth in�is socti4a: ' � ' Subd.2. Iuformatiaa req�dred to be�rea individuaL .+.n iadividusl askcd�n svPB�Y Peva�c or confideada]data cuaoerniag himcalf s�.tl1 be informed of: (a)�tie parposa an6 ia�eadcd u.se of the�equesud daac wir.hin the eollccting tnu ageucy,poGGca1 subdivisian,ar,s�at�wide SysTcm; (b)whcnc�r he m�y refvse oc is IcgaU,y requin.d to supply ihe requesud dara;(e)aqy kaows causequeoce arising fmm his supplyiag or refusing to supply privac�or confidcn4al da�:and{d)rhe idrntity 0[o[her persons or eaaries autho�ized by sta�e ac frdcral law ro recaive ri�e da�. This cLquiremcac shali uoi apyIy�++hen as�isu3ividual is asked m supPly investiga4vc ds�.Pursu��co sccpon 13.82.subdivisioa 5.co a 1aw cnforcement o[�icar- 'i1u c 'ssioner of�evenue m� acc chc noace rc ired under is subdivision in thc indivEduai - come rax ar o crev�x iet'w1d inSiYSJCLI4 insteffd Oeo thbSt f6R�'.-. ' Suhd.3. Access ta d.ata by indiridual. Upon reqvesc�o a rzsponsiblc aud�oriqr,su iAdividuaI shsll be iuformed wheihcr kc is th�s►+b3eec of storcd data on individuals.and wGcther ii u ciass�¢d as public,Pt'IVSLC OC COIIF1dCR�J�. ��1�S f1ilG�lCC�L'QL�CSL.�3AC�lYiQt112 WISO 1R�1C Su{7�CCL af stored privau or pu6lic data on individuals sha.G be shown s�e data wichou�xny chssgc W him and:it he dcsiro9,sh�i1 be infarmcd of tke eonr�ac , and mcaning af if�at dara. After au iadividua[h,�s bccu Shawn dse priYat�dacs and inParcaed of ks meaniag,�e da�nr,cd Ao[he discloscd W hIm for siz manihs thereaher uNcss a dispure or aeu0n pursua��W chss secdon is peading or addiaanal dara oa tha iadi�idusl has bcen cqlleered or escxtcd. Tttc reapansiblc aurhoriry sha1S provide cepics of dze privuc or publie da�upan request by rhe individ�l subjcot of thc da�s. Tha raspansbte�urharisy raaY�+cquira�he roqucstin8 person W pay�he setual cosrs aF inakin3.eerrifying�and comps7ing tha eopicS. :: . _ Thc responsible au�honq+sha11 eompfy immcd�accly.iF pessible,wirt►say t�quest made pursuant w dtis subdivision.OC wi�in ftvo days o! che date af�he requc5t,excluding Satt�n�i�ys.Sundays and Icgal hoti4ays,if imruadiar�compliance is uat possb�c. If k�cannot cor.�pty with rhe nqacs� � wichin tftat rime,he shall so infoRct�he individual.and auy hsve an addirionat�ve days within which ao aa�ply witii thc inques�exciuding SAnudzys, Sundays uid 1eg�1 hotidays. � - � ,, � Subd.4. Pracedurr whea data is not accurate ar complete. An tttdividaaF tnay eoatest d�e aceuracy pr comp[etcrtcss of publk or privatL data conocming himself. To excrcise[his right,an u�dividual shali nnofy in wriong d�c rospOnsibie authAYiry describing d1�t�ntre of Cu diSagi+eemcnG 'fhc responsibIc auchoriry shall widtin 30 days ei�her: {a)a4rnet che da1�f�und to bc inacwratc oY incomplcte and aaempt to aadfy pass recipi�ucs of inaccuratc ar incompie�e dsrn,iaeluding rccipiencs named by thc ind[veduaI;or(b)notify the individual rhat he believes iha datt to'be corc�ecs-^Dat� in dispu�e shall be Qiscloscd oNy if thc ind►vidual's siacemen�oP disagreemea�is includtd with the dise[oscd data. , The dcterminatian of dia responsible au�horiry m�y be appe�lcd pursuanf W�he pmvisi0ns dC�c adaunisffaavc procedur�ac�nlatin3 to Conus�ed cascS. , . AATA p1tIVA.CY AIlVI$Olt`Y In acCOrdancC with M.�• I3.Q4, Subd.2, "RiQli�s of subjects of data",we wauld Iike ta inform yoa that your xeques� foC a peruliL or 3iCense ftOrii �e City o�Orono or atxy of its depaztment5 ttlay requirt yoa to furnish certain pri'vate or confideatial infarmacion. ' � You are notified that: c� . : , i. 1'he inform�[ioa you fusn,is�wilI be u5ed to determiue your qu�iftcatioa for the permit or Iicense requeste�. �. You snay refus� to supply data, but rafusal mzy rcquire that th� City deny the permii or licease. 3, The information may be shartd wir.h other local, sta[t or federal �gencies to the ezteat necessaxy to ptocess the permiE Or liceaSe. � 4. Tf your requts�ed ptrnxii or license requires Couneil actiorl to approvt, some infDrmacioa may beeome public. ' S. You have certain rights under M:S. 13.04 (available upou reques�} to revicw private daca oa yousself. 6. Your full namc is required to process dais applie�iion or permi[. 1�n - - �co u ,� . . Firsz � Middtt �t S ...3,� S�T �/c .... _ . . � �ss �/ _ �,,3// �6.�— ��—.�.� 3 �P� ��` - � -- �� Su�e � Zip Phonc T einderstsnd my rights as stated above. `�� C�� ' y. . . $l$S11A3CC , Feb-16-2005 09:36am From-CITY OF ORONO +9522494616 T-59T P.Op2/D05 F-410 ' • . CREDEN�AL C�RT�CATION API�LICATION CITY OF ORONO 2790 I�eUy Parkway, F.U. Box 66 Crys�al Bay, MN 55323 �bon�: 249-4600 • � Business: fP�C'� Y�1`Co��c� t� b�n Phone:763- `�6f/_,?�7;3-��y/G-J'�63 / r— cAusincss and I�omc3 . A.CtCu'eSS' �.5�.3 b �`��`' l9�c. /� ' City:,�/�Q�,�� Grovc State:�.�. Zip;,,,?S'3l� Type of License Held: NIaster Plum'ber� House Maver Oiher • State License No.0055� t�m F.�cpirationDate /�- 3/- D� Have you ever had a license revoked?� 'When Where � NOTE: The City dQes nat have a specia� bond form to use. 1'ruof of Workers Compensa�ion insurance cov�rag� is required for a11 contractors. Check kind af trade applying for: Septic Contractor (Required: R�PCA Tnd.ividual Sewage Treatcuent Systems License) � ' � House Mo�ver (Required: $2,000 Bond, 10-�0-100,000 Insurance) 1VZecha�icaI (Required: Copy af$25,404 State Band& 10-50-100,000 TnsuranCe) �� Flumber (R.equire�: $2,000 Bond, 10-So-100,OQQ �asurance �R � a copy oF the State Plumbing Insurance/Bond) 1Vrunicipal conz��ctions (sewer/water) Yes ��No Fire Sprinkler xnstallers (Required: $2,aoo BoAa, 1G-SQ-IQO,OOd) Work shall not comm�nc� until this application laas bEen approved and required p�nmits ar� issued. Please iz�dicate any other persons authorized by you to apply for ' persnits: v��it2/1 c `1' �Co/y� �_ The undersigned hereby malces application to the CiCy o� Qrono, Minn�sota, for credential eertifieation as i�,dicat�d above, subject to the laws o�the State of Mi�tesota and the Ordinances of the City of O�ano. Ali applicacians are subject to a ten (10} day approval period. Xf disapproved, written notice wiI1 be sent. // 1 Sigaaatuze: ��!�� z�— , Date: o�— ��- �,,,,�'r' .: - �--,�, D�T�i TIME ✓ CITY OF ORONO CALLED IN d`�`�" INSPECTION N E SCHEDULED �� PERMIT N0. D ��OMPLETED ADDRESS 3075 �a'3'��L�� OWNER CONTR. I�'�Q.fr�L/�'�('CO"L��. TELEPHONE NO. 7�0 3 T CO T aI d��aJ � DESCRIPTION �� 01 FOOTING 11 MECHANICAL 18 EXCAV/GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q OS FINAL 14 SEWER HOOK-UP O6 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP = 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL � 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL Z OWNERICONTHACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � � O �. � O � W � Q � Z W � W � � d � WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY � ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. _; pHOTOTAKEN INSPECTOR WILL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALI INSPECTOR O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-46�� OwnerlContrac or site: Inspector. - White Copyllnspector's File Canary Copy/Site Notice �� '"— DATE TIME ITY OF ORONO CALLED IN ��I O��S INSPECTION,�IOT�IC.�E SCHEDULED _3_/�� "__�� PERMIT NOl ,�'?�� COMPLETED _ lC1•✓U ADDRESS -��;r7 S ��-� ��i `��-U J � � OWNER CONTR. ,/Z�C�/'�� - TELEPHONE N0._ �G�� -�' � �� .3 � DESCRIPTION G/�'`��' tf�'�(� �� l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING � 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS � Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q 05 FINAL 14 SEWER HOOK-UP O6 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPL4INT v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP = 09 PLUMBING RI 23 SE IC FINAL 35 HARD COVER REMOVAL � 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YO ._YES_NO � COMMENTS: '.c?i ! I iY�a � tz3 f�� /(� .' �(�� /�t a � { � �� i,C�c2.n1 ; ' ` �yJ � � ' ' 0 � � 0 � w � Q � Z W � W � � d W� WORKSATISFACTORY:PROCEED f-, PROJECTCOMPLETE W ❑ CORRECT WORK&PROCEED ',� ISSUE CERTIFICATE OF OCCUPANCY O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑ CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CAL�TO ARRANGE ACCESS. Call for the ne t inspection 24 hours in advance. (952� 249-46�� Owner/Contr�on � e: Inspector. .� White Copyllnspector's File Canary CopylSite Notice ��, � �ij D TIME CITY OF ORO�O CALLED IN v INSPECTION � SCHEDULED � �� PERMIT NO. coMP�ETEo ADDRESS 307�� v��''� '�1i� OWNER CONTR. � TELEPHONE NO.— (P� Z �� BD� � DESCRIPTION ��n� �/ � �`�� l� 01 FOOTING 11 MECHANICAL R 18 EXCAV/GRAD G/FILLING � 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS � Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP = 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � � O � � O � W � Q ti Z W � W � j GW 1 WORK SATISFACTORY:PROCEED �ROJECT COMPLETE V � ❑CORRECT WORK&PROCEED r ISSUE CERTIFICATE OF OCCUPANCY W � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERING �` " PERMANENT �O/�,3/� ❑ CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ PHOTOTAKEN INSPECTOR WILL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the ext inspection 24 hours in advance. (952� 249-4600 OwnerlCont site: Inspector. White Copyllnspector's File Canary CopylSite Notice