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Home My WebLink About1997-009812 - gas line addition �' PERMIT � CITY OF ORONO 2750 Kelley Parkway- P.O. Box 66 PERMIT TYPE: Crystal Bay, Minnesota 55323 Permit Number. _ _„ ' (612) 473-7357 Date Issued: SITE ADDRESS: DESCRIPTION: �-�; ; r,�. � }—,, : �' , s S t� ��- r ._ .�I,t�•_�L i`?°� ` � C'i 1 ! {_� s ;-'�#1�;;��i11i��t !J�_ I�:; . , _. �"._.rtit.��. . . i �%�}"�.'":i��_ � �' .l s_?i�;l..t=`�.�" ;.�`•�;'�'•1 REMARKS: FEE SUMMARY: ... _._. _ _ .... .... :. ....: .. . fv :: ,^:S.i> 6 � i.;+� 'J.7f�:.: ' ' " ' ".r.�.�.��_„_�i - _ _ "'? 'r-.• r \, CONTRACTOR: -- - OWNER: " - - =� :�., ;;; �, - - -: - ;. : .�µ� � ...._.;.� .. _. . �� _� ,. ,. ,: .�., , -�, .: , ,:��; � �-� .:� ,:; . , � , ._ :. _..: _ _ �..;._ , ��.,��. . ..__.__. ; _� , _. , ._ - : � � _. , � ... r>��.: -..�. rs:k,a ':_��'•u.:t. � . . . : , ._ , .� . '`.:,._ , .. .. '# . _ _ . ., . . _ . . . . . ,_ �.,. .,._ . .. :, _ ... . . .. k_ .� . . ., , ; ,� � . : > . �.�_ .< r < ._ . . , . .: . . .. : . „� :: _ ._ . .. ��... r..,_ ..:� _� . .. . _ .. .„ .,� ,. �:. �... at . .•�.� . ... , .=: . . .. . .. . . . , , .,. . . . } _ . . .,. ,;.. .,,.` .� ... e tr . - , .. . « _..1 - ��. .,_ ._ - . . f . . � ..� ,r�,x� � ._ . : ., . .y � :' �. _ { A , L . .. .................__.._.�,�� 5'? . _ � . . " J �' �i .,,,�.��-' _.__..... / � .�'` � APPLICANT%PERMITEE SIGNATURE ISSUED BY:SIGNATURE �� - � �8�� CITY OF URONO APPLICATION'FOR PLUMBING PERMIT �lox hb (2750 Kelley Parkway) Crystal Bay, MN 55323 GENERAL INFORMATION 1. You may apply�for plumbing permits by mail or in person at the City offices. � 4 2: Permit cards will be sent by return mail a�ter a review is.complet�i. PERMITS ARE NQT VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST.NUT BEGIN UNTTL THE PERMIT CARD IS POST'ED ON THE JOB SITE. 3. Plumbing permits may be.issued ONLY to licensed plumbing cont�actors and to property owners residing in the dwelling. 4. When any new construction or remodelutg is involved, a sepazate 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 testcd before it is covered. Call 473-7357. 24-hour notice required. . Instruction� Co��lete all items on this application. : Compute the permit fee. .Sign and date the certificatiaii. INCOMPLET� APPLiCATIONS WILI,NOT BE PROCFSSED. If you have ' questions, call A�73-7357. �'lease check one: New � Addition Repair, Re lace P Rssidential � � Comme�cial JO� STTE: Oied�'U�) �v(�l./� . L��oeZ t�. Zip: . Owner's Name: � Telephone Number: Mailing Address: City: D�o�vv Zip:� SS35—� Contractur'sName:��`v �irw �Lr�M6�� ; ��.�TelephoneNumber. ��73=�'j� � � Mailing A.ddresss/�go t�,wh,�z�„� �'31vl�- �„City;. L.��6-L�kr�ip: S's:�,r� �'LUMBING�FIXTURE SCHEDULE , . ` FIXTITRE BSMT YST 2ND OT�ER ; FIXTi7RE: BSMT 1ST�' '2ND �: . O`THER : 't'YPE FL' FL <W TYPE FL_: FL Water Closet " '��F�� La�+atory Sewer Ejectbr' Bathtub �dry.T�y . Shower W��r Kitchen Sink Water�Teater Disposal Water Softener Dishw��sher Wet $ar Sillcocks Misc (list) : �� 1Y�!r ; ��f Tia/\/ ' � ' PERMIT FEE CALCULAI'iON 1. 1.25% of Contract Price* or Miniinwn Fee ($35.041 '2�D %-- x .�125 $ , (conFract price) 2, State Surcharge. ** Add the State Building Cade Division _ Surcharge to each permit: _ x .0005 $ _ -(contract;price) or �.�Q, whichever is greater 3: Post��,and Handlin� (Only mail-�in applicatidns) � $ 1.50 4,. TOTA;T; I�ERMIT FEE tAdd lin�s 1-3 ahove) $ � * CQNTREICT PRICE or JQB CO5�'means,the actual or estimated dollaz.amount eharg�cl�or the.permitted work including materiais, labor, pro�t,.a�d other fixed costs. It is the amount to be chaiged to thE customer for-the yvork ddne. If auy,tnaterial, equipm�nt,latior;or installation aire furnished b}r tttC owner, tenarit;�r any`�ther party the reasanable market value of such items must be acided to.the eswnatefl cost or contract price.€or permit fee purposes. In the event that::there is a dispute on the amount of the job cost, the Ciry may x�c�uest,,the submission df a signed co��±,of"the'.actual contract. ** Tlte STATE SURGHARGE.is .0003 of the.contract price.urtder $1,000,0OO,�r $.50 - �"+hichever,is ,greater. For valua�ions over.$1,OOU,000:ca11 the�D�P�rtment:of Inspectional Serv3oe$ fot the grice. > :� �' � C� �r �ssuaz�eeL��xa��umbing Peinnit, agrees to do �11 , The w�tlers�g�ed her�b,�+ applies to.th�z �y.� �voric in stnct a�cprda�ce wifish; tl�� o�duaa�cce� o"�th� C�ty` .�.tl�e�regulat�anS:of the St�te�of ,,IV�i��s�ot�; xand:certifies ;that .all statemen`ts �a;de an ;t�is application ar� complete, true and , � . . . . � _ ;C9�T�Gt. : A icant'�S,�g�tu Date• �`� —��' �� 1��. •� , � , ,- , � ' . ..'�,.- . ` .. " �. - 'E�� _,. =.. �. . �. . ' �:... . . . ...., . . . .. : ,.. . � _ � ' � � :� : :., .,. - ..,.. � . : ` � . .... . .�. . ... ��.