HomeMy WebLinkAbout1999-011665 - backflow to irrigation ERMIT
�ITY OF ORONO PERMIT TYPE:
�%5`�<elley Parkway- P.O. Box 66 - - -�..u;.�
'� Gryst�,l Bay, Minnesota 55323 Permit Number: -��-'�'=�::::,
Date Issued: `-`'� �'=`'='��`
(612) 47�-7357 - - -
SITE ADDRES�:
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�t�NTRACTOR: �- ��`�°�°i ?���}��T� -- OWNER:
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APPLICANT-PERMITEE SIGNATURE ISSUED BY:SIGNATURE
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CI�'� O�' Q�It�1�T� APg�C�T�I�I`�FOTt P�,�J1�Il�C �'ERN�T'r
Box 6b (2750 Kelley Parkway)
Caysta� �ay, h�T 55383
GENERAL I1�FORMAITON
� L You may apply for plumbing permits by mail or in person at the Ciry o�ces.
2. Permit cazds will be sent by return mail after a review is completed. PERMITS ARE NOT VALID
UNTIL YOU RECENE A PERbIIT. 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 properry owners residing
in the dwelling,
4• �hen 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 tesced before it is covered. Call 249-4600. 24-hour notice required.
�nstt�uctiorts Complete all items on this applicatian. Compute the permit fee. Sign and date
the certification. IlVCOMFL,�1'E APpI,ICATIONS WILL NOT BE PR�CFSSED. If you have
questions, ca11249-4600.
Please check one: �New Addition Repair �teplace
_� Residential Coanmercial
30B S�s � �(1/`�{�/"J /�S� �i : `�S' Ca
Owner's Name• .� g 5 �' �
o Telephone Niamber: �3.5= �a� �
1Vla�ing �ddress: Z�-- �.�. � � City: D��--*�� �iP s _�3'3-�cA
Contractor's l�iamea J tIGS �'eiephone N�unber: g3���3 4
�Iailiag Address• _�D�- t'j� q�,�,� �/. City: Zip:_ S5'34�3
I'�:UMBIN� rl'�XTL��' SCI3�EI�ULE
FIXTURE BSIVIT 1ST 2ND OTHER FIXTURE BSMT 1ST 2ND OTHER
TYPE FL FL TypE g�, pL
Water Cioset Floor Drains
Lavatory Sewer Ejector
Bathtub Lanndry Tray
Shower Washer ' �
Kitchen Sink Water Heater
Disposal Water Softener
Dishwasher Wet Bar
Sillcocks Misc pist)
d��Fl�w -� r,.�,���Y��
�E+�'E' ��+ l�t����.�1��1
1. �.25% of�ontract Pr�ce�` or I�r��ee 6�3s.�aZ ��
-�� x .0125 $ ;
(contract price) �
2. State Surcharge. ** �dd the Sta.�e Builc�ing Cade Di�ision Y ���
Surcharge to each perinit. x .0005 $ "
. (contract pnce) �
or $.50, wluchever is greater �
3. Fostage and Handlin� (C3n1y mail-in applications) ' $
4. T07fAL PF.RMIT �EE ' (Add lines 1-3 abov�} $ ��� •
� CONTI�.4CT PRICE or 30B COST meaas 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 chuged to the
customer for the work done. If any material, equipment,labor,or installation are furnished by the owner,
tenant or any other party the reasonable market value of such items must be added to the estimated cost
or contract price for permit fee purposes. In the event that there is a dispute on the amount of the job cost,
the City may request the submission of a signed copy of the actuat contract.
** The STATE SUItCHAItGE is .0005 of the contract price under $1,000�000 or $.50 - wluchever is
greater. For valuadons over $1,000�000 ca11 the Department of Inspectional Services for tt�e price.
The undersigned hereby applies �o the City for issuance of a Plumbing Pernut, agrees to do all
work in strict accordance with the ord'uiances af the City and the regulations of the State of
Ivlinnesota, and certifies that a state en made on this application are comglete, true and
correct.
Applicant's Signature: I)ate:
�
DATE TIME
CITY OF ORONO CALLED IN l a'b ��
WSPECTION NOTICE SCHEDULED �' �-7 10`.�
PERMIT NO. l J (�(oS- COMPLETED
ADDRESS S�S� �tv Yl`�� �aSS
OWNER CONTR. �A'h ���..
TELEPHONE N0. G�J3 ��(oJ�'
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Q 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
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Q 05 FINAL 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
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= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J�•_. LUMBING FIN 36 FOUNDATION/REMOVAL
� OWNEHICONTRACTOR TO MEEf YOU:_YES_NO
� COMMENTS:
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W� ❑WORKSATISFACTORY:PROCEED �, PROJECTCOMPLETE
W ❑CORRECT WORK&PROCEED - ISSUE CERTIFICATE OF OCCUPANCY
� ❑ CORRECT WORK,CAIL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN
l CITATION ISSUED
�;STOP ORDER POSTED.CALL INSPECTOR
i_=' INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Call for the next inspect' 4 hours in advance.473-7357
OwnerlContr tor o e:
Inspector.
White Copyllnspector's File Canary CopylSite Notice