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Home My WebLink About2016-00762 - in-ground sprinkler � �� CITY OF ORONO * 2 0 1 6 - 0 0 7 6 2 * 2750 KELLEY PARKWAY DATE ISSUED: 06/29/2016 ORONO,MN 55356- (952)249-4600 FAX: (952)249-4616 ADDRESS : 517 FERNDALE RD N PIN : 36-118-23-14-0007 LEGAL DESC : LJNPLATTED 36 118 23 : LOT 000 BLOCK 000 PERMIT TYPE : SPRINKLER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : BACKFLOW DEVICE ONLY NOTE: - NO SPRINKLER HEADS WITHIN 10 FEET OF SEPTIC DRAINFIELD. APPLICANT SPRINKLERS 50.00 STATE SURCHARGE FLAT-OTHER 1.00 RIGHTMARK LLC 1VIqIL-IN FEE 2.00 P.O.BOX 343 BUFFALO,MN 55313- TOTAL 53.00 (952)75&6237 Payment(s) CHECK 10223 53.00 OWNER ANDERSEN,STEVEN&STACIA 517 FERNDALE RD WAYZATA,MN 55391- 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 separate permits. All provisions of laws and ordinances goveming this type of work shall be compied with whether or not specified herein.'Chis 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 aze requested in conformance with the State Building Code.This permit may be revoked at any time for due cause. � �� P l �l /� Applicant Permitee Signatur Date Issued �ignature Date � RECEIVED �pN City of O�ono FQR IT S ONLY o P.o.B°"� JUN 2 9 2016 +aate R�ed:_��lo 2750 Kelley Parkway r., �,,.�t �'/�'�` � Crystal Bay,MN 55323 Penmit� ��f►� "'U v ,/tO�� y�, �' Phone:(952)249�600 � l�KESH�a`�` Fa�t: (952)249-4616 �i��F�R�� APi��$Y� .�.. . Amount� __ J� 4�—T CITY OF ORONO — IRRIGATION PERMIT PERMIT CODES: City of Orono, Minnesota State Piumbing Code Sprinkler/Residential/�avm Sprinkler/Blank Sprinkler/Residential/Badcflo�ro Device Ony/Blank Job Site Address:__J�� 1�1 a�-�. � ('Y � 1 Owner: ��TC,�UVI�(�,-PI��,�'1 Telephone Number: Mailing Address: `) t� t'F'�Y1 G�.�1'�. �G� .,v � ��ty: � 2�- z�p: 55�� I � ` ✓ q - Sprmkler Contractor: �.� elephone Number �2 �� lJ�� Contact Person: � License � � � \��.Q L"� �� Mailing Address�.� �� , �t rn � :, �� WATER SUPPLY: Lake❑ Well❑ City❑ BACKFLOW DEVICE: AVB ❑ PVB� Make 1f� IJI�'L�_Model Year of Manufacture�"� "� Quantity INSTRUCTIONS 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. GENERAL INFORMATION 1. You may apply for Irrigation 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. Page 1 1 � r City of Orono Irrigation Pennit,Continued 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. Working 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 PERMIT FEE CALCULATION 1. Permit Fee: $ 50.00 2. State Surcharge $ 1.00 3. Mail-In Fee $ 2.00� 4. TOTAL PERMIT FEE(Add lines 1-3 above) $�C' ,-�� The undersigned hereby applies to the City of issuance of an Irrigation System Permit, agrees to do all work in strict accordance with the ordinances of the City and State regulations, and certifies that all statements made on this application are complete, true and correct. Applicant: Date:(�� v�``�' Approved: Approved with Corrections: Denied: Reviewed By: Date: Page 2 ASSE International Pressure Vacuum Breaker Assembiy (PVB) ASSE Standard #1020 Field Test Report Qwner o roperty % '' ' � Address -� � u City ��-� Zip Code �S 3 � Occupant o Praperty (if different from ownerj � Ce �"� Occupant Address C�ty State Zip Code Manufacturer of Assembly: �l � f�� Model #: � Z- (� Size of Assembiy: � Serial#: �' Location of Assembly and Equipment or System lication: ; G �'`-� �,.� ;,^ - ' ,� Test Equipment: , �,,- -.. � �� Manufacturer: +'��. :� --- � �� Model #: �� - � Seriai #. � � f '�� "'; ! Calibration Date: � -- M^�-' � - Date test was performed:�,�me test was performed:�(, ��Static Line Pressure: � '�� ; Air inlet Valve Check Valve Shut Off#2 ; ; j j ' Leaking ( ) ; ; ! Faited to Open ; Ciosed Tight { �/� � Leaking ( } � ' lnitiai TesE � ' ' i � Opened at�psid ; Pressure Drop Across � Closed Tight (� � Check Valve#1`� ?.� psid � i � Describe parts and � � � � repairs when needed � j � i , I 1 ; � Leaking ( ) ; ! � Opened at�7'�psid Closed Tight (� � Leaking ( } ! ! Finaf Test Pressure Drop Across ' Ciosed Tight ( � i Check Vatve#1 �_�--psid i Certified Tester (print) ,�_� + `, , 1-�.�, ,,1� -�_ Assembly Final Test Address ^--�_`� - -�. �t ! � Performance �- . i._ ..,-1� _ 1 - City _ `� State `�1 Zip -- '> Pass �. , _; _ -. -, . . Phone :: -- � ,�I ; - �# License�- �'- �'� �'� C rtifi ion# - -' �' ; ;-,. � Fail � � ` Date: �O� � � � Signature �.--� Comments or Recommenda#ions (cont;nue to otner siae,if neededj: � i i !� f-.,c � . � " �,�... DATE TIM�'�/ CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED PERMIT NO.�1��6�7� COMPLETED _� ADDRESS� �u'/1i��I� /P� /Y• OWNER TELEPHONE NO. CONTRACTOR � DESCRIPTION v'3• ��r�"�s•s��^- ly ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT �/�FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP _�❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL v ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 OWNER/CONTRACTOR TO MEET YOU:_YES_NO ��., COMMENTS: a� � �`� • /J f6 v�hGd ' /�� r� ti�l�✓ � v 0 1� c�s �,�-,�:..., !v ' o� �.�� t -' �. � 0 � W � wr7f K L'vr,��pl-�Z`s� Q � z W � � � j �s/ �N-� ��c.0 d W� ❑WORKSATISFACTORY:PROCEED ROJECTCOMPLEfE W ❑CORRECT WORK 8 PROCEED ❑ IS CERTIFICATE OF OCCUPANCY 0 O CARRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (J52� 249-4600 Owner tractor on site: ��G Inspector. ��= �� White Copyflnspector's File Canary CopylSite Notice /1 ! DATE TIME'�1 CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED PERMIT NO..�lL�6�7� COMPLEfED ��- ADDRESS� �u'�4�� /P•� /Y• OWNER TELEPHONE NO. CONTRACTOR � DESCRIPTION v3• ��r�'��i��^• ty ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT �FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP �� W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL _ J ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 OWNER/CONTRACTOR TO MEET YOU:_YES_NO c�.� COMMENTS: a V`� - /Jfbvr,�c.d ' /9� �r�ti�l�✓ 0 /'1 G4�s �J r`i-�•... !v ' �'� �� ,5��.�L�+�t — � a O � W � wvrK �'�m.�ol� Q � z W � � W � /�s/ �r•-C ��.2 � a � ❑WORK SATISFACTORY:PROCEED ROJECT COMPLEfE W ❑CORRECT WORK 8 PROCEED ❑ IS CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN INSPECTOR WILL RETURN D STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call forthe next inspection 24 hours in advance. (g52) 249-4600 Owner tractor on site:��e�G Inspector. ��.= �s�- White Copyllnspector's File Canary CopylSfte Notice