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CITY OF ORONO PERMIT NO.: 2oiaoo�og
2750 KELLEY PARKWAY
ORONO,MN 55356- DATE ISSUED: 08/16/2010
952 249-4600 FAX: 952 249-4616
ADDRESS : 2295 LONGVIEW CIR
PIN : 03-117-23-22-0025
LEGAL DESC : LONGVIEW 2ND ADDN
: LOT 002 BLOCK 001
PERMIT TYPE : PLUMBING(>$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIXTURES-MULTIPLE
NOTE: PLUMBING FIXTURES:
(1)EACH: WATER CLOSET,LAVATORY,SHOWER,LAUNDRY TRAY,WASHER BOX,AND(1)LAUNDRY TRAY IN GARAGE
VALUATION OF PLUMBING 3200
APPLICANT PLUMBING FIXTURE FEE 50.00
FRANK MOTZKO PLUMBING STATE SURCHARGE PLBG(VALUATION) 5.00
4201 ZARTHAN TOTAL 55.00
MN 55416-
(952)929-6048
Minnesota State License#: 058694PJ
OWNER
DUGAN, BARBARA
2295 LONGVIEW CIR
LONG LAKE,MN 55356-
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 dces
not grant permission for additional or related work which requires sepazate
permits. All provisions of laws and ordinances goveming this type of work
shall be compied with whether or not specified hereia 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 l80 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections aze
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
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pplic t Permitee Sign ure Date Iss d By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
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2750 Kelley Parkway � � � � . r �
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�t (952)249-4600 �� :,
CITY OF ORONO—PLUMBING PERMIT
(All Commercial permits must be approved by the Building Official or Inspector)
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1. You may apply for plumbing pernuts by mail or in person at the City offices. Applicarions will be
reviewed and a pemut will be issued within two working days.
2. Pernut 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 TAE
PERMIT CARD IS POSTED ON THE JOB SITE.
3. Plumbing permits may be issued ONLY to licensed plumbing contractors and to properiy owners
residing in the dwelling.
4. When any new construction or remodeling is involved,a separate building permit must be
obtained.
5. All work must be done in accordance with State Code requirements.
6. All work must be inspected and air tested before it is covered. Call(952)249-4600.
(24-48 hour notice required)
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�Residential ❑Commercial(Approval Required)
❑New ❑Additional ❑Repairs �Replace
❑ In Accessory Structure?
*You will need arior aaproval and may need CUP.(Per Orono City Code,Chapter 78,Article I�
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Site Address: ��95 `�-(f7'��w ���/Z,�,
Owner: 6,42,P, /��J��� �� Mailing Address: .�m�
City: a/��ou O Zip: ���S�a
Home Phone: �i _-�'�SS��(., Alternate Phone:
�Con�cac�or�o�iat�on ` �� �'' � � �� :
Contractor: �v�2 {�/��'�� 6'�� Contact Person:
Address: ��� �2.��A,!-r'�, State Bond#:
City: Zip: Expiration Date:
Phone: � Altemate Phone:
❑ Insurance-Current:
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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 Tray 1 `
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Shower � Washer
Kitchen Sink Water Heater
Disposal Water Softener
Dishwasher Wet Bar
Sillcocks Miscellaneous /�
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❑ Yes,this section applies
The replacement of a Residential fixture or an liQ ance that meets all three of the following requirements:
1. Does not require modificarion to electrical or gas service.
2. Has a total cost of$500.00 or less;excludine the cost of the fixture or appliance: and
3. Is improved,installed or replaced by the homeowner or licensed contractor.
Skip next secrion,if this applies; Cost of Permit $ 15.00
State Surcharge $ 5.00
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee $
(Permit Fees Continued On Next Page)
2
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If above does not apply;follow guidelines below:
1. CONTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00)
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�Ob-" x.oi2s$
(contract price) (minimum$50.00)
2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of$5.00)
x.0005 $
(contract price) (minimum$ 5.00)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $
■ * CONTRACT PRICE or JOB COST means the actual or estimated dollaz amount charged for the
permitted work including materials, labor,profit,and other fixed costs. It is the amount to be charged
to the customer for the work done. If any material, equipment, labor or installations are fumished 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 perxnit 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 actual contract.
■ **The STATE SURCHARGE is .0005 of the contract price under$1,000,000 or$5.00—whichever is
greater. For valuations over$1,000,000 call the Building Department at(952)249-4600 for the price.
The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do all
work in strict accordance with the ordinances of the City and the regulations of the State of
Minnesota, and certifies that all statements made on this application are complete, true and
correct.
Applicant's Signature: Date:
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� D E TIME ✓
CITY OF ORONO CALLED IN �
INSPECTION NOTICE SCHEDULED - /D l0;D�
PERMIT NO.���-DD �d8 COMPLETED
ADDRESS aa9s �$%�, �1�
OWNER TELEPHONE N0. 7�3 �3� �pq�
CONTRACTOR .:7�h�-� �d'�/�-�
� DESCRIPTION ��'�'�'6 � ��
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� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL
Q ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
� ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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��.lOLQ$K SATISFACTORY:PROCEED ❑ PROJECT COMPLEfE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CAIL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WlLL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTOARRANGE ACCESS.
Ca11 for the next inspection 24 hours in advance. (952) 249-4600
OwnedContractor on site:
Inspector. � . � � �
White Copyllnspector's File Canary CopylSite Notice