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CITY OF ORONO * Z 0 1 3 - 0 1 2 Z 6 *
2750 KELLEY PARKWAY DATE ISSUED: 1U18/2013
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2180 NORTH SHORE DR
P1N : 10-117-23-31-0098
LEGAL DESC : MARKVILLE
: LOT 000 BLOCK 003
PERMIT TYPE : PLUMBING(> $500)
PROPERTY TYPE : RESIDENTIAL
CONSTROCTION TYPE : FIXTURE
NO"I�E: WATL;R SOF'I'ENER
VALUATION OF PLUMBING 21500
APPLICANT PLUMBING FIXTURE FEE 268.75
FINKEN PLUMBING STATE SURCHARGE PLBG (VALUATION) 10.75
3423 COUNTY RD 74
P.O. BOX 7190 MAIL-IN FEE 2.00
ST CLOUD, MN 56301- TOTAL 281.50
(320)258-2005 PAID WITH CC# 7358
Minnesota State License#: 6453�9
OWNER
ORONO LLC, MSSP
855 VILLAGE CENTER DRNE#382
ST PAUL, MN 55109-
AGREEMENT AND SWORN STATEMENT
l'he work for�vhich 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 does
not gran[permission for additional or related work which requires separate
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified herein.'1'his permit will
expire and become null and void if construction authorized is not
commenced within l80 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time afrer 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 use.
� �� � i �, � 3 (,e___ C:��.a-� J � � � � �3
Applicant Permitee Si ture Date Issued y Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
FROM :Finken Companies FRX N0. :3202582006 Nov. 18 2013 01:52PM P1
��r� City of Orono
�y P,O.Rox 66 — �
275U Kcllcy Parkwuy 4 �
Cryatel 9uy,MN 55323
(952)249 460U Main �I
(9S2)249.4516—Fex �
��' c?� CITY OF ORONU^PLUIV�RING PCRMIT
1� sH �` (All Commerciat Permits Must be Approved by the StAte Prior to City Approval) ��
htt�://www.dli. o '(;L,U/PUI�/�e �lumb�Iflnrcva �.�df
1. You mAy spply for plumbing permits by mail or in pet9on at the City offices_ Applicatians will be
reviewed and a permit will be issued within two wurking d�ys.
2. Permit cards will be sont by return mail after a review is completed. PERMTTS ARE NOT
VAI,TI�LTNTTL YOU RECEiVE A PERMIT. l�(?ItK MUST NOT BEGiN UNTIL THE
Y� �1�[iT CARD 15 POSTED ON THE.JS2D�lI'E.
3. Plun,hing permits may be issuetl ON�,Y to licensed plumbinb contractors and to property owners
residing in the dwelling.
4. When�ny new construction or remodeling is invnlv�d,�separate building permit must be
obcnined.
5. All work musc be done in aca�rdance with State Code requircmcnts.
6. All work must be inspected qnd air tested hefore it iw covcred. Call(952)249-4600.
(24�48 hour noticc required)
�1 �' " 1 2�, .P .'4"�.rl
[�Residcntial Q Cotnmercial(Approval Rcquired)
❑ New ❑AddiCional ❑Repairs �Replace
[� in Acccssory Structure?
'You will n I and may need CUP.(Per Omno City Code,Chapter 78,ARicle 1V)
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Site Address: �1 $� �4�"`� ��f�- ��'��`Q--
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Owner:U'�1IP@ 1'� ..._....___ Mailing tAddress:
,� � ��t�''1
c�ry: 1l��uz� , lv�N _� z�p: �-��-�a I
Home Phone; a�� ��'� �"� Alte�rnate Phone:
h�
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Contractor; 'n�`�'� V I��� Contact Person: ��'v� �t,`P�!��
Address: ��� � � ��' State Bond #: „�G b�"���°�
C�ty; S� •�(�4 ,7.,ip:��iP 3�� �xpiration Date: 1� � � 1
Phone: �������""�'0� 111terna.tePhone: _,,,,
[�] Insurance—Current: G �-�-Gc�ltiY��'
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FROM :Finken Companies FAX N0. :3202582006 Nov. 18 2013 01:52PM P2
FiXTURE ASMT 1 2 OTHE?R FIXTURf.'s BSMT 1 2 OTHER
'TYPE t�L Ft_ TYYE; FI., FL
Water C:loaet Floor Drains
Lovatory Sewer Ejectot
g��b Laundry Tray
Shc�wer Washcr
Kitchen Sink WAter l-Teaker
plypos� Water Soi�cner
Dishwasher Wel Bor
$ilfcacks Miscel laneous
[] Yes.this section applie4
The raplacement nf only one ii�sidential tixture..Dr anolianco that meete all three uf the following
requirements:
l. not require modification to electrical or gas service.
2. Has a otal co of�500.00 or less; in the cost�f the fixture or appliancc:and
3. Is improved,installed or replaeed by the homeownet or licensod plumbin�ccmtrtteWr.
Skip next section,if this a�+plie�; Cost of Permit $ 15.00
State Surohargc S 5.�
M�il-Tn Fee(If Applicable) $ 2.00
Total Te��nit Fee S
(Permit Fees Contlnued Qn Next Page)
�
FROM :Finken Companies FAX N0. :3202582006 No�. 18 2013 01:52PM P3
Tf sbove dces not a�pFy;follow guidelines beiow:
1. C�N'I'RACI'PRTCE '� is 1.25%of cantract price with a(Minimum Fee of$50.00)
�c�l S00•�tJ x.otz5$ ��$ •7�
(cnntrscs price) (minimwn 5.�.00)
2, y�TATE SURCAARGE
. . . .......--
x.0005 S
lcona�act pricc)
3. POS'I'AC�E&HANDLING(Only on M�i1-in Applications) $ 2.00
A. TOTAI.PERMIT FEE(Add Lines l-3 Above) $
• * CONTRACT PR1CL or JOB C4ST means the ac,tual or estimated dollar amount charged for the
pern,itted work including materi�►ls,labor,profrt,and other fixed costs. !t is the amounc to be charged
to thc customer fc�r the work done. if ony meterial,equipmont, Isbor or in9tallAtions sre furnished by
the owner,tenant�r any crther party,thc rca�nablc market value of such items must be added to thc
estimated cost or contract price fr,r pern»t fo� purposes. ln the event that there is a dispute on thc
amount nf the job cost,tho City may request the submiesion of u si�ned copy of the actual contrxc�.
The undetsl�tltxi hcreby Applies to the City for issuanqe pf a Plumbing Fermit, agrees to do a.11
work in strict accordttnce with the ordittapCes of the City and the regulat�ons of the State of
Minnesota, and eertifies that �11 statemecrts made on this applieation are complete, true and
correct.
Applicant's Signature: _ Date: �1 13 __
3