HomeMy WebLinkAbout2016-01008 - replace water softner �
CITY OF ORONO * z 0 1 6 - 0 1 0 0 8 *
2750 KELLEY PARKWAY DATE ISSUED: 08/22/2016
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 3825 NORTH SHORE DR
PII� : 17-117-23-22-0046
LEGAL DESC : SHERRI LAKEVIEW ESTATES
: LOT 004 BLOCK 001
PERMIT TYPE : PLUMBING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : FIXTURE
NOTE: REPLACE WATER SOFTENER
VALUATION OF PLUMBING 500
APPLICANT PLUMBING FIXTURE FEE 50.00
STATE SURCHARGE PLBG(VALUATION) 0.25
CULL[GAN SOFT WATER SERVICE CO. MAIL-IN FEE 2.00
6030 CULLIGAN WAY
MINNETONKA,MN 55345- TOTAL 52.25
(952)912-7379 Payment(s)
CREDIT CARD 5107 52.25
OWNER
SUTTON,GREGG
3825 NORTH SHORE DR
MOLJND, MN 55364-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable Ciry approvals,and the
State Building Code. This permit is for only the work described and does
not grant 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.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 are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
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Applicant Permitee ignature Date Issued ignature Date
�8/22/2016 10:28 FA� 9529�35049 CULLIGAN MNTKA C�1002
� City of Orono �� ;FOR E ONLY;: �
�`� d P.O. Box 66 �'Dete;�Rece'i;ved: ����;'r,i�'� '�h?
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CITY �F ORONQ— PLUMBING PERMiT
(AI) Commercial Permits Must be Approved by the State P�ior to City Approval)
http:l/www.dli.mn.aov/CCLDlPDF/qe plumbplanr�vaQp.pdf
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1. You may apply for plumbing permits by mail or in persan at the City of�ices. Applications wifl be
reviewed and a permit will be issued within iwo working days.
2. Permit cards will be sent by return mail a�ter a review is completed. PERMITS AR� NOT VALID
UNTIL YOU RECEIVE A PEI�MIT. WORK MUST NOT BEGIN UNT1L THE PERMIT CARD IS
POS7ED ON THE JOB SlTE.
3. Plumbing permits may be issued QNLY to licensed plumbing contractors and to property owners
residing in the dwelling.
4. When any new construetion or remodeling is involved, a separa#e building permit must be obtained_
5. All work must be done in accordance with State Code requirements.
6_ A11 work must be inspected and air tested before it is covered. Gall (952)249-4600.
(24�48 hour notice reyuired)
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�Residential ❑ Commercial (Appro�al Required) [Hac�low Device:❑A.VB ❑pVB]
�New ❑Additional ❑ Repairs � Replace
❑ fn Accessory Structure?
*You will need pria�anprvval and may need CUP. (Per Orana City Code, Chapter 78, Article 1�
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Site Address: _� � � 5 f��r�-�1� ��n p�. ��
Owner: ��Qa .���ov-. _ Mailing Address:
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City: Zip: S.S,�,�'I
Home Phone: 11�3� �� , 7�9� Alterna#e Phan�:
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Contractor: Cantact Person: ��
Address: 603o GULLIGAN WAY $fate 8ond #:
(�952) 933-7�U�
City: Zip: Expiration Date:
Phon�: Altemate Phdne:�S�,- g 1 a -�3_l_'�
[f Insurance—Current: �
Page 1
• 08,/22/2016 10:28 FAX 95293a5049 CULLIGAN DINTKA �OOa
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FIXTURE BSMT 9'ST 2ND UTMER FIXTURE BSMT �sr 2N0 OTNER
7YPE Floor F1oor NPE Floor Floor
Water Closet Floor Drains
��tQry Sewer Ejector
Bathtub Laundry Tray
Shower . Washer
Krtchen Sink Water Heater
Disposal Water Softener
Dishwasher Wet Bar
Sillcocks Miscellaneous
" I� �PdSl7 ��. ,p��e,,,, m 4?,7.+P.�!I!RC.eii Y�`�3'��,w li!i'+'�" � '� �� r'6' m +WN �"��
1. GONTRACT PR10E "is 1.25% of contract price with a(Minimum �ee of$50.00)
x .0125 $
(contract price) (minimum $50.00)
2. STATE SURCMARGE
x _0005 $
(contract price)
3. POSTAGE 8� HANDLING (Only on Mail-tn Applications) $ 2.00
4. TOTAL PERMIT F�E (Add Lines 1-3 Above) � •�5
* CONTFZAGT PR10E or JOB COST means the actuaf or estimated dollar 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, fabor or installations are furnished by the
owner, tenant ar any other party, the reasonable market value of such items must be added to the
estimated cost or contract price for permit fee purposes. In.the event t(�at 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.
�ni�r �w �~ an"��.u ry ,��6C�'4e?� ��4'�II�!�!l����� rh���t��{Ic�'."�'' '�� ,9.d .n"G�i �6�9 "" Wwul�'�:II
The undersigned hereby applies to thE City for issuance of a Plumbing Permit, agrees to do al{ 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 apptication are complete, true and correct.
ApplicanYs Signature: Date: � " ��.� �b
Building Official/Inspector. Date:
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