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HomeMy WebLinkAbout2011-00749 - backflow preventer , r CITY OF ORONO PERMIT NO.: 2011-00749 , 2750 KELLEY PARKWAY ORONO, MN 55356- DATE IssuED: 07/27/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 2587 KELLY AVE PIN : 20-117-23-14-0021 LEGAL DESC : TOWNSITE OF LANGDON PARK : LOT 004 BLOCK 005 PERMIT TYPE : SPRINKLER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE . L�1d�I SPRTNKI ER , �'>,' '� � 1. ���' �� � �CL— NOTE: BACKFLOW PREVENTER APPLICANT SPRINKLERS 35.00 DORAN ENTERPRISES INC. STATE SURCHARGE FLAT-OTHER 0.50 1440 KELLY DRIVE GOLDEN VALLEY, MN 55427 TOTAL 35.50 (763)546-5066 Minnesota State License#: 58224PM OWNER WARE, ALEXANDER 2587 KELLY AVE EXCELSIOR,MN 55331- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable 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 specified herein.This permit 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 applicant is responsible for assuring all required inspections are requested in conformance with the State Building Code.This permit may be revo a t o cause. � � ��� �G�I/ � � pplicant Permitee Signature Date Issued By � ature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER AN DESCRIBED ABOVE. . 'O,¢p�O City of Orono ° ;g��������p�� P.O.Box 66 �: 2750 Kelle Parkwa � � �� ��� � � �� � Y Y 1�a�e�cC�usd �'eTm�Y# ��� Crystal Bay,MN 55323 � ���_ y Phone:(952)249-4600 Fa�c: (952)249�616 �j�pp�y�d$y � tl�ntsurit�: ��7 CITY OF ORONO—LAWN SPRINKLER PERMIT Job Site Address: �,� � 1ti �w( �' Owner: C-C.rW' Ll7 f.��.P Telephone Number: 1,�l� ���' 93�3 Mailing Address: City: Zip: Sprinkler Contractor��l h L�1��*S� Telephone Number: ��� q �� ��f�7 Contact Person : �'J •��D''L��-, License#: S�'�y !�- `Vj Mailing Address: Z� � r' �D �F' � � cS" �77 WATER SUPPLY ake ❑ Well ❑ City� LOW DEVICE vB ❑ PVB � (/'a.�ccc�M bre�� Mak�_,(� Model � Year of Manufacture Quantity / Sprinklers: HYDRAUI.IC CALCLTLATIONS 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: $ 35.00 2. State Surcharge $ .50 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 statem on this application are complete, true arid correct. : Applicant Date � ��' •��J� . ..................................... Approved Approved with Corrections Denied, Reviewed By: Date 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 for 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 IN5TRUCTIONS 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.