HomeMy WebLinkAbout2003-P06354 - water softner � , PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: P06354
Crystal Bay, Minnesota 55323 Permit Type: Fixtures
(952) 249-4600 Date Issued: 5/23/2003
SITE ADDRESS: 375 Leaf St
Long Lake,MN 55356
PID: OS-117-23-14-0059
DESCRIPTION:
Proposed Use: xesidenriai
Permit Class: Plumbing
Permit Type: Fixtures Pemut Sub-type(s): Water Softner
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: PermitFee: $ 15.00 Valuation• $ 0.00
State Surcharge Fee: $ 0.50
Misc.Fee: $ 1.50
TOTAL FEE: $ 17.00
APPLICANT: �lligan Soft Water Service Co. OWNER: Mr. &Mrs.Crowther
6030 Culligan Way 375 Leaf St
Minnetonka,MN 55345 Long Lake MN 55356
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICf COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND Sf ATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
( r
�
APPLICANT P RMITEE SIGNA RE ISSUED BY SIGNATURE
Conies: 1-File(SiQnitures Required), 1-Arn�licant, 1-Monthlv Reuorts, 1-Assessin�, 1-Finance Page 1
✓
,l .
CTT'Y OF O1ZON0 APPLICATION FOR PLUMB�YNG PERIVLIT
Bo� 66 (2750 Kelley Parkway)
Crystal Say, 1VIN 55323
C'T�IERAT,�L'vFORMATTO
I. You may apply for plumbing permiu by mail or in person at che Ciry offices.
2, Permit cards will be sent by recura mail after a review is completed. PERMITS ARE NOT VALTl�UNTII,
YOU REC�IVE A 1'E�2iVIIT. WORK_MUST NOT BEGIN UVTIL TH13 PERMIT CARD 1S pOSTED ON
TI-I I�B STTp-
3. Plumbing permiu may be issued ONLY to licensed plumbing coauactors and to propeny owners residing
in the dwelling.
4, When aay new construcdon or remodeling is�mvolved, a separate building permit musc be obtai.aed.
5. All work must be done in accordance�,r�irh the: Stau Code requirements.
6. A.Il work musF be inspecxed and air tested t�efore ic is covered. Call (9�2) 249-4600. 24-hour norice
required.
Instruc�ic►ns Complete a11 items on this application. Compute the permit fee. Sign and date 1he
certification. INCO�IPLETE APPLICATYUNS WIr.L NOT BE PROCESSED. If you have
questions, call (952) 249-4600.
Please check one: �_ New _ Addition Repair �2eplace
�_R�sidential ^_ Commercial
J'OB SITE: ��1`�� L-���-� �{-. Zip: ������
Owner's Name:�ou C �C�S `��w+�� �' TeIephone Nurnber; �i���-- �5 Z 1
Mailing Address: =� �� �� � (�-V�c�vc City: �- �v���u Zip: (��c��n-� )
Contractor'sName: CULLIGA��! WATER COiVDITiONIN(�elephaneNumber:
Mailing Address: 6030 � City: Zip:
, ,
PL,�2���.�?��rx� sc�oF:nvl.E
FI�TLTR� BSMT iST 2W OTHI:R �'T�'`�TURE BSMT 1ST 2ND OTFIER -
TypE FL, FL - TYP� FL PL
'Water Closec Floor Drains
I.avaro Sewer Ejector
Bathcub Laundrv Tra
Shower Washer '
Kitchen Sink Water Heacer .
Dis osal Water Softener �
Dishwasher Wet gaz
Sillcocks Misc(Iist)
, �
PERNiYT F�E CALCY3I,ATTON(Sl
20 2 State Statute � Yes, This Section Applies
The replacemeni of a Residential f xture or appliance that meets all three of the following
requirements:
1) Does not require modification 1.o electrical or das service.
2) Has a total cost af$500.00 or less; excludinQ the cost of the fixture or appliance:
and
3) Is improved, installed or replaced by the homeowner or licence� contractor.
Skip next secuon; Cost of Permit $ T5.00
� State Surcharge $ .S�
Mail Tn Fee $ 1.50
If above does not apply, follow guidelines below:
1. Contract price* is .0125 % of job with a NTinimum Fee of ($35.00�
x .0125 $
(canir;ict price) �minimum$35.00)
2, State Surcharge. *�` Add the State Building Code Division a (IViinimum �'ee of $ .50)
x ,0005 $ �
(conU�act price) (minimum$ .50)
3, Post��e and I�andling (Only mail-in applicarions) $ 1_50
4. TOTA�. PERI�IIT F'�� (Add lines 1-3 above) $
* CONTF.ACT PRICE or 10S COST means thE:actual or esrima�ed dollar amoun�charged for the germicted
work includiq,materiais, labor,profit, and od�er fixed costs. Tt is rhe amount[o be charged to the customer
for the work done. If any material, equipmer�t, labor, or installation are furnished by the owner, tenan�or
any other parry th�reasonable market value cf such i[ems must be added to the estimated cost or contrac�
� priee for permi�fee purposes. In the event thac there is a dispute on che amount of the job eost, the Ciry may
request the submission of a signed copy ot thr. actual contract.
** The 5T'ATE SURCHARG�is .0005 of the contract price tinder 51,000,000 or S.50 -whichever is greacer.
For valuations over�1,000,000 call the DepaRmen�of Easpection Services for the price. .
The undersigned hereby applies to the City f��r issuance of a Plumbing Permit, agrees io do all
work in strict accordance with the ardinanc�:s of the City and the regulations of the State of
Minnesota, and certifies that all stacements made on this application are complete, true and
correct. I �
Applicant's Sinnature: �-- �Z �� �.�:1.0 � �' l� �_.� Date: -�}� Z� -�C��