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Home My WebLink About2017-00649 - blackflow for sprinkler CITY OF ORONO * Z 0 1 7 - 0 0 6 4 9 * -, 2750 KELLEY PARKWAY DATE ISSUED: 06/14/2017 � ORONO,MN 55356- (952)249-4600 FAX: (952)249-4616 ADDRESS : 3017 NORTH SHORE DR PIN : 09-117-23-32-0002 LEGAL DESC : CORONADO BEACH LK MTKA : LOT 000 BLOCK 000 PERMIT TYPE : SPRINKLER PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : BACKFLOW DEVICE/TESTING/REPAIR APPLICANT SPRINKLERS 50.00 STATE SURCHARGE FLAT-OTHER 1.00 STEWART PLUMBING,INC. MAIL-IN FEE 2.00 13025 GEORGE WEBER DR SUITE#1 TOTAL 53.00 ROGERS,MN 55374 Payment(s) (763)42&1833 CREDIT CARD 3122 51.00 Minnesota State License#:plbg-PC000474,mech-MB003262 CREDIT CARD 3122 2.00 OWNER BLUE,JAMES 9610 SKY LA EDEN PRAIRIE,MN 55347- 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 pertnits. 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 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 /1,:� revoked at any time for due cause. �1� � ,_ . r, ,,�;� �� u �� , �y � � Applicant Permitee Signature ate Issued By ignature Date Stewart Plumbing, Inc. 7634281733 p.3 • ,��p�� City of Orono �� FOR C17Y USf ONLY Q P.O.Sox 6fi I Date Received: r , -- l� `�� `' 2750 Kelley Parkway , "�L�`� �� ` � � Crystal Bay,MN 55323 Permit# ��) / "��i f�� '\ � ,�,� �� Phone:(952f 249-4600 I AppfoVed By: L/T—� \\t�,�`�'�H�at;'/ Fax: (952)249-4876 I /y' � -__ , Am�unt$: CZ. ClTY OF ORONO -- IRRIGATI4N PERIUIiT PERMIT CODES:City of Orono, Minnesota State Plumbing Gade Sprinklerl Residential/Lawn Sprinkleri Blank Spnnkler 1 Residenfial 1 Backflow Device Only/Blank Please Check One: New❑ Addition❑ Job Site Address: .3�I 7 ��'+'� :��^�G Y� �'r'�i�� Owner: , L�fY1.E' S ��ft' Telephone Number: MailingAddress: �fli�L% .s� �L�-J'1t City. ��t� �i�G'it'�� Zip: �`�..��I S�rinkier Corrtractor: S�I.t�7lt L f" f�j?!'L°��r -rLTelephone Nurnber �� 7C�:�- �� Contact Person: I�y!'17— !�C� V License Mailing Address ��'�� C�;�� ,�.�+'Y �j �� tl�r'S /�?r'1� �5 5 -7 y WATER SUPRLY: Lake❑ Wel!❑ City� BACKFLOW DEVICE: AVB� PV8[� Make �.J , �I�-�1�}� _Model 7�U Year of Manufacture U!7 Quantity l iMSTRUCTIONS Complete alk items on this application. Incomplete applications will not be processed. ]f you have questions, ca(I (952)249-4600. You will be notified by phone when the permit review is cornptete. GENERAL INFORMATlON 1. You may apply for Irrigation System permits by mail (P.O. Box 66, Cryst21 Bay, MN 55323)or in person at the City offices(2750 Kelley Parkway). Submit plans for review with this application. 2. PERAIIITS ARE NOT VALID UNTIL YOU RECEIVE A PERM17. WORK MUST NQT BEGIN UNTIL THE PERMIT CARD IS POSTED ON THE JOB SITE. , 3. When any new construction or remodeling is invotved, a separate building permit must be obtained_ 4. AIt work must be done in accordance with City and 5tate Suilding Cade requirements. Page 1 Stewart Plumbing, Inc. 7634281733 p.4 s 'City of Orono Irrigation Permit,Continued 5. Two (2)sets af working pian5 shall be submitted for approval to the authority having jurisdiction before any equipment is installed or remodekod. Deviation from approved plans uv�ll require permission of the authority having jurisdiction. Workina plans shall be drawn to an indicated scale on sheets of uniform size with a plan of the site so that tf�ey can easily be duplipted and shall show the following data: a. Name of owner and occupant b. Location,incfudi�g streeE address c. Point of compass d. Location of septic system if applica�e e. Source of water supply f. Pipe s;ze g. Pipe location h. All control valves,check vafves,drainpipes i. �Vame and address of cantractor 6. All work must be inspected(final). Call{952}249-460U.24 ta 48 Hour Notice Required PERMIT FEE CALCULATIOIV 1. Permit Fee: $ 50.00 2. State Surcharge $ '!•UO 3, Mail-In Fee $ 2•00 4. TOTAL P�RMIT FEE(Add lines 1-3 above} $ J�� C�U " The undersigned hereby applies to the C9ty of issuance of an Irrigation System Pennit,agrees to do all work in strict accorciance with the ordinances af the City and State reguiations,and certfies that all statements made on this application are complete,tnre and correct. Applican� !��.L�GE- �'�� Date: (��"� � Approved: Approved with Co�ons: Denied: Reviewed By: Date: Page 2