HomeMy WebLinkAbout2010-01134 - water softener f
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� CITY OF ORONO PERMIT NO.: 2010-01134
� 2750 KELLEY PARKWAY
' ORONO, MN 55356- DATE ISSUEv: 1U18/2010
952 249-4600 FAX: 952 249-4616
ADDRESS : 2650 MAPLERIDGE LA
PIN : 21-117-23-24-0050
LEGAL DESC : SHORE HILLS
: LOT 000 BLOCK 000
PERMIT TYPE : PLUMBING(<$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER SOFTNER
NOTE: WATER SOFTENER
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APPLICANT PLUMBING FIXTURE FEE(<$500) 15.00
CULLIGAN SOFT WATER SERVICE CO. STATE SURCHARGE PLBG(<$500) 5.00
` 6030 CULLIGAN WAY
MINNETONKA,MN 55345 MAIL-IN FEE 2.00
(952)912-7379 TOTAL 22.00
PAID WITH CC# 0597
OWNER
NOVACHIS,ANTHONY&JANEL
2650 MAPLERIDGE LA
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 dces
not grant permission for additional or related work which requires sepazate
permits. All provisions of laws and ordinances goveming this rype of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if consVuction 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
revoked at any time for due cause.
- l,�-�CI.t.�P d�J /�/ �� //Z� � i � i (�
AppLcant Permitee Signature Date Issue y Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
11/18/2010 10:23 FAX 9529335049 CULLIGAN MNTKA �J002
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FOR C[TY 1.T3E ONLY
City of Orono ��Recan�d:� /a Permit� 0�0�D�� �.3�
��°�o p.o.�x�
2750 Kelley Parkway
� r Crystal Hay,MN 55323 Approvod By; Amount S:O?a��
� ' '' 6� (952)249�1600
CITY OF ORONO—PLUMBING PERMIT
(All Commercial permib must be epproved by the Building Offieial orinapecwr)
GEI�TERAL TNFORMATION
l. You may apply for plumbing permits by mail or in person at the City offices. Applications will be
reviewed and a pertnit will be.issued within two working days. .
2, Permit cards will be sent by retum mail after a review is completed. PERMITS ARE NOT
VAI.,JD UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BES�IN UNTIL THE
PERMTT C IS POS D ON THE JOB SIT�.
3. Plumbing permits may be issued ONLY to licensed plumbing contractors and to property ovmers
residing in the dweUing.
4. When any new construction or remodeling is involved,a separate building permit must be
obtsined.
5. All work must be done in accordance with State Code requirements.
6. All work must be inspected and air tested before it is cov�ed. Call(952)249-4600.
(24-48 hour notice required)
TYPE OF PERMIT
Check All That A 1
�Residential ❑Commercia((Approval Required)
�New ❑Additional ❑Repairs ❑Replace
❑ in Accessory Structure?
*You�vill ueed�rior aunroval end may need CUP.(Per Orono City Code,Chapter 78,Article 1V)
Job Site/Ovmer Information:
Site Address: 0��5 D {Y�ao�eri�g Q Lk►ti2
Owner: ��ti f10 V 4 C����_ Mailing Address:
City: Zip; SS 33 I
Home Phone: �b3—��l 3- 017� Alternate Phone:
Contractor Information:
Contractor: Contact Person: 1�1�►.�
CULLIGAN WATER C�N.DITIONiNG
Addr�� ���-��GA� WAY State Bond#:
MIIVNETO , 56345
C��,: (952) 933-7200 Zip: Expiration Date:
Phone: Alternate Phone: 950� -9 ia - 7317
� ❑ Insurance—Current:
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11/18/2010 10:24 FA% 9529335049 CULLIGAN ASNTRA f�003
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' e,�. �� ro 5� � !�'4-' i � �� ° �',�1..y��n¢�"` y�Y.. •.��'h�i7�.;i5'�i
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FIX'f'URE BSMT 1 2 OTHER FIXTURE BSMT 1 2 OTI-IER
'fYPE FL FL TYPE FL FL
Water Closet Floor Drains
Lavatory Sewer Ejector
g��b Laundry Tray
Shower Washer
Kitc6en Sink Water Heater
Disposal Water Sot�ener
Dishwasher Wet Bar
Sillcocks Miscellaneous
Y �,
T.,M
� Yes,this section applies
The replacement of a Residential fixt�re or appliance that meers all three of the following requirements:
1. Dogs not require modification to electrical or gas service.
2. Has a co of$500.00 or less;exc ' the cost of the fixture or appliance:and
3, is iraproved,instaUed or replaced by the homeowner or licensed contractor.
Skip next section,if this applies; Cost of Permit $ 15.00
State Surcharge S 5.00
Mail-tn Fee(lf Appliceble) S 2.00
Total Permit Fee $
(Permit Fees Continned On Next Page)
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11/18/2010 10:24 FAX 9529335049 CULLIGAN ffiNTRA f�004
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If abovc dces not apply;foUow guidelines below:
l. �ONTRACT PRICE *is 1.25%of contract price with a(Minimum �ce of 550.00)
x.O125 S
(contract price) ( 'nimum$50.00)
2. STATE SURCHARGE *"Add the State Bldg Code Div,Surcharge(Mini um Fee ot SS.00)
x.0005 $
(contractprice) (minimu S S.OQ)
3. POSTAGE&HANDLING(Only on Mail-In Apptications) $ 2.0
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) S o�a-0(�
■ * CONTRAGT PRtCE or JOB COST means the actual or ostimated d�llar amount charged for the
permitted work including materials,labor,profit,and other fixed costs. It is the amount to be charged
to the customor for Ure work done. if any material,equipment, labor or installations are furnished by
the own�r,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 pwposes. 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 STA7'E SURCHARGE is.0005 of the contract price under$I,000,000 or�5.00—whichever is
greater. For valuations over S 1,000,000 call the Suilding Departrnent 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 striet 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, bve and
correct.
Applicant's Signature: Date: �1� �Q ' �(,
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