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HomeMy WebLinkAbout2002-P04839 - water softner � PERMIT fiCITY OF ORONO Permit Number: 2750 Kelley Parkway - PO Box 66 P04839 Crystal Bay, Minnesota 55323 Permit Type: F�Xn�res (952) 249-4600 Date Issued: li2gi2oo2 SITE ADDRESS: 855 Forest Arms La MOUND,MN 55364 P I D: 07-117-23-12-0013 DESCRIPTION: Proposed Use: Kesidential Permit Class: Plumbing Permit Type: Fixtures Permit Sub-type(s): Water Softner DETAILS: Approved per resolution #: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 35.00 Valuation: $ 200.00 State Surcharge Fee: $ 0.50 Misc. Fee: $ 1.50 TOTAL FEE: $ 37.00 APPLICANT: Culligan Soft Water Service Co. QWNER: ALAN&BARBARA GOLZ 6030 Culligan Way 855 FOREST ARMS LA Minnetonka,MN 55345 MOUND,MN 55364 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. /' L � ---'� ,� /) / '��22it� ;�� ,'�1 .��i ;�;�,'�Y�,�x� A� '`""'� L APPLICANT PERMITEE SIGNATURE ISSUE , YSIGNATURE � Copies: 1-File(Sienitures Repuired). 1-Aoplicant, 1-Monthlv Reports, 1-Assessin�, 1-Finance Page 1 � / fi �1 y �✓ � � �� �� J CITY OF ORONO APPLICATION FOR PLUMBING PERMIT Box 66 (2750 Kelley Parkway) Crystal Bay, MN 55323 GENERAL INF'ORMATION 1. You may apply for plumbing pernuts by mail or in person at the City offices. 2. Permit cards will be sent by return mail after a review is completed. PERMITS ARE NOT VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS POSTED ON THE JOB SITE. 3. Plumbing pemuts may be issued OIVLY to licensed plumbing contractors and to property owners residing in the dwelling. 4. When any new construction or remodeling is involved, a separate building permit must be obtained. 5. All work must be done in accordance with the State Code requirements. 6: All work must be inspected and air tested before it is covered. Call 249-4600. 24-hour notice required. Instructions Complete all items on this application. Compute the permit fee. Sign and date the certification. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have questions, call 249-4600. Please check one: � New Addition Repair Replace ��Residential Commercial JOB srrE: s�SS �c���- �-�r�s �c�.r1e_ z�p: ���y Owner's Name: A�. �'�D�Z Telephone Number: '� Mailing Address: L��`��a --S��3S City: Zip: Contracto���� CONDITIONING Telephone Number: Mailing Addre��� City: Zip: , �952� PLL1rVISING FIXTURE SCHEDULE FIXTURE BSMT 1ST 2ND OTHER FIXTURE BSMT 1ST 2ND OTHER TYPE FL FL TYPE FL FL Water Closet Floor Drains Lavatory Sewer Ejector Bathtub Laundry Tray Shower Washer Kitchen Sink Water Heater Disposal Water Softener t Dishwasher Wet Bar Sillcocks Misc (list) � ,` PERMI�' FEE CALCULATION 1. 1.25% of Contract Price* or Minimum Fee ($35.00) �, ���. x .0125 $ r:�� . �� (contract price) 2. State SurcharL�e. ** Add the State Building Code Division + �� Surcharge to each permit. x .0005 $ (contract price) or $.50, whichever is greater 3. Posta�e and Handlin� (Only mail-in applications) $ 1.50 4. TOTAL PERMIT FEE (Add lines 1-3 above) $ 3"7 � C�.� * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the permitted � work including materials, labor, profit, and other fixed costs. It is the amount to be charged to the customer for the work done. If any material, equipment, labor,or installation are furnished by the owner, rea�:r �r �*+y orher p�rty ihe re?�onable market value �f such items must be added to the esti�nated cost or contract price for pemut fee purposes. In the event that there is a dispute on the amount of the job cost, the Ci�y may request the submission of a signed copy of the actual contract. ** The STATE SURCHARGE is .0005 of the contract price under $1,000,000 or $.50 - whichever is greater. For valuations over $1,000,000 call the Department of Jnspectional Services for the price. The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do all work in strict accordance with the ordinances of the City and the regulations of the State of Minnesota, and certifies that all statem�nts made on this application are complete, true and correct. Applicant'sSignature: � � Date: �a ��-Qv�—��