HomeMy WebLinkAbout2012-00792 - lawn sprinkler � ' �
CITY OF ORONO * 2 0 1 2 - 0 0 7 9 2 *
2750 KELLEY PARKWAY DATE ISSUED: 08/14/2012
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 3350 FOX ST
PIIV : OS-117-23-44-0008
LEGAL DESC : FULLERTON ESTATES
: LOT 004 BLOCK 001
PERMIT TYPE : SPRINKLER
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : LAWN SPRINKLER
APPLICANT SPRINKLERS 50.00
ABLE SPRINKLER STATE SURCHARGE FLAT-OTHER 5.00
PO BOX TOTAL 55.00
ELK RIVER, MN 55330-
Minnesota State License#: PCO2639
OWIVER
BIGOS,NANCY
3350 FOX ST
LONG LAKE, MN 55356-
AGREEMENT AND SWORN STATEMENT
l'hc work for which this permit is issucd shall be performcd according to
the approved plans and specifications,applicable City approvals,and the
Sta[e[3uilding 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 with whether or not specified herein.This permit will
espire and become null and void if construction authorized is not
commenced within 180 days ot�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 rcquired inspections are .
requested in conforniance with the State Building Code.This permit may be
revoked at any time for due cause.
r_�� �a����11 � l ' �° l i �'' $l l ��`
Applicant Permitee Signatu, Date ssued y Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRBED ABOVE.
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� ��0 ���� City�of OrOnO CIT SE ONLY
/ ¢ � `� P.o.sox 66 �7
1 � ;; ��`�� 2750 Kelley Parkway Date Receiv :� ennit# ���41� � �
a � � �� ��� Crysrdl Bay,MN 55323 �-,
��'� '}�� ��o�� Phooe:(952)249-4600 Fax: (952)?49-4616 Approved By: Amount$: ✓i
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CITY OF ORONO—LAWN SPRINKLER PERMIT
nEaMrr co�Es�►N-HousE> �� '� ti l���` 1���^-�..� �
Spnnkled Residential/Lawn Spnnkler/Blank � �''
Spnnkler/Residential/Backflow Device OnlyBlank � � �
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Please Cl�eck One: New ❑ Addition ❑
Job Site Address: ���j,�'D fv n �(
Owner: /If� ,�j� G U � Telephone Number: �%d -��/ ` 6 6a�
Mailing Address: v���';7 �!��.�'' /? �t,-J ��',
City: 0 t�:,,—'� Zip: �J .�' " y
Sprinkler Contractor: ���/_���r ;,��,:_�;,r' Telephone Number: ��„2 ` ,;��'„C. -� �f��'S�'
Contact Person : f?r��r.� �a i�;�'� License#: � � ��� � �
Mailing Address: ,¢E[�r_ .S,�r;'� (�C�er F� B�� �t`��� l'-C.l�� r�; VY9e*- /��:a� ,�.� 3,5b
WATER SUPPLY
Lake� Well ❑ City❑
BACKFLOW DEVICE
AVB ❑ PVB ❑
Make Model Year of Manufacture Quantity
�rinklers:
HYDRAULIC CALCULATIONS Design Data:
Area of Application: Sq. Ft.
Coverage per Sprinkler: Sq. Ft.
No. of Sprinklers:
Total Water Required: GPM
PERMIT FEE CALCULATION
1. Permit Fee: $ 50.00
2. State Surcharge $ 5.00
3. Mail-In Fee $ 2.00
4. TOTAL PERMIT FEE(Add lines 1-3 above)
$
The undersigned hereby applies to the City of issuance of a Sprinkler 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 �� �v'''� !/ Date � " � �' ' f V�.
Approved Approved with Corrections Denied
ReviewedBy: ��������C.�, _ Date �� -1 �►d`—
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CITY OF ORONO
APPLICATION FOR LAWN SPRINKLER SYSTEM PERMIT
GENERAL INFORMATION
1. You may apply for sprinkler system permits by mail (P.O. Box 66, Crystal Bay, MN
55323) or in person at the City offices (2750 Kelley Parkway). Submit plans far 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.
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.
Workin�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
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.