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Home My WebLink About2010-00911 - water softner 1 r , CITY OF ORONO PERMIT NO.: 2010-00911 ' 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISS[1Ev: 09/28/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 2195 FRENCH LAKE RD PIN : 10-117-23-21-0006 LEGAL DESC : JOHNSTONS FRENCH LAKE 2ND ADDN : LOT 001 BLOCK 003 PERMIT TYPE : PLUMBING (<$500) PROPERTY TYPE : RESIDENT[AL CONSTRUCTION TYPE : WATER SOFTNER NOTE: WATER SOFTENER APPLICANT PLUMBING FIXTURE FEE(<$500) I5.00 APPLIANCE CONNECTIONS STATE SURCHARGE PLBG(<$500) 5.00 13 Li DANITA CR. SHAKOPEE, MN 55379 MAIL-IN FEE 2.00 (952)445-4803 TOTAL 22.00 Minnesota State License#: 057209PM OWNER GOTTSCHALK, ANDREW& ERIN 2195 FRENCH LAKE RD WAYZATA, MN 55391- AGREEMENT AND SWORN STATEMENT i�he work for which this permrt is issued shali be perfomled according to the approved plans and specifications,appGcable 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 governing this type of work shall be compied with whether or not specitied herein.This pennit 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 applican[is responsible for assuring all reyuired inspections are requested in conformance wi[h the State E3uilding Code.This permit may be revoked at any time for due cause. ��C�.i.�� /o d�;�C�-ui � �%/l� Applicant Permitec Signature Date Iss I3y Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. � / , ,� ,� F CTT USE ONLY � City of Orono O¢ �� P.O.Box 66 Date Received�� 1�Permit# �d �!/ • 2750 Kefley Parkway ��,�r Crystal Bay,MN 55323 Approved By: Amount S: �� O` (952)249-4600 0 CITY OF ORONO-PLUMBING PERMIT (All Commercial permiu must be approved by the Building Official or Inspector) GENERAL INFORMATION � 1. You may apply for plumbing permits by mail or in person at the City offices. Applications will be reviewed and a permit will be issued within two working days. 2. Pertnit 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 permits may be issued ONLY 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 �,��'VE� obtained. 5. All work must be done in accordance with State Code requirements. 5. All work must be ir.s�ected and air tested before it is covered. Call(952)249-4600. SEP 2 7 �L�� (24-48 hour notice required) TYPE OF PERMIT ORC7N0 Check All That A 1 � ��Residential ❑Commercial(Approval Required) ❑ New ❑Additional ❑ Repajrs �Replace ❑ In Accessory Structure? *You will need arior aaaroval and may need CUP.(Per Orono City Code,Chapter 78,Article IV) Job Site/Owner Information: %'� ��..� �--� i �� Site Address: ;-;Z�� ,- , r i � ,l,/ � � � {,:�'.�' � ,� , `, ,} f I , , /�' ' L ��Q Owner: ��1�-��'�'� �� I �t�`�'�` � Mailin Address: �� rr�-+ (�- �G4��C �`-�- � c�ry: ��ty`��'�'��"'�`L��- z,p: ��=��:-�%l / Home Phone: s�'`�� 7�� , - � �' Alternate Phone: Contractor Information: � ' Contractor: Contact Person: Addres� -� �=��:�10f1S �1'�ate Bond #: , , �itc� �.i' City: ;�.;�;:.::_ -� � �i��, ExpirationDate: � & . Phone: ��-445-��,� Alternate Phone: - ❑ . Insurance-Current: . � 1 � / /. FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 2 OTHER TYPE FL FL TYPE FL FL Water Closet Floor Drains , , � Lavatory Sewer Ejector Bathtub Laundry Ttay Shower Washer Kitchen Sink Water Heater � v Disposal Water Softener j � �� Dishwasher Wet Baz Sillcocks , Miscellaneous � ��.PERMIT FEE CAL�LTLATiQN(S) ;- ;.� �� - �' BASED OFF'-2002 STATE STATUE ❑ Yes,this section applies The replacement of a Residential fixture or appliance that meets all three of the following requirements: 1. Does not require modification to electrical or gas service. 2. Has a total cost of$500.00 or less;excludina the cost of the fixture or appliance: and 3. Is improved,installed or replaced by the homeowner or licensed contractor. Skip next section,if this applies; Cost of Permit $ 15.Q0 ' . State Surcharge $ 5.00 � Mail-In Fee(If Applicable� $41,,;� . � Total Permit Fee � $ , � -. ' � .� � (Permit Fees Continued On Next Page� . 2 �