HomeMy WebLinkAbout2011-00120 - water softner • CITY OF ORONO PERMIT NO.: 2011-00120
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUED: 02/22/2011
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 4017 NORTH SHORE DR
PIN : 07-117-23-44-0005
LEGAL DESC : HIGHWOOD LAKE MTKA
: LOT 000 BLOCK 000
PERMIT TYPE : PLUMBING(<$500)
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER SOFTNER
NOTE: WATER SOFTENER
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
BRYAN,KATHLEEN
4017 NORTH SHORE DR.
MOUND,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 City 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.
Applicant Permitee Signature Date Issu By Signature nature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
02/22/2011 12:22 F :i 9529335049 CULLIGAN MNTKA 81002
pF�OOR USE ONLY
al 0
P.O ox of Orono Date Received "P/�1 Permit# o?.O/�60/
66
I t. k� Crystal 2750 elley Parkway Bay,MN 55323 Approved By; Amount S: Gc��'��
;:l fit (952)249-4600
CITY OF ORONO—PLUMBING PERMIT
! (All Commercial permits must be approved by the Building Official or Inspector)
GENERAL INFORMATION
1. You may apply for plumbing permits by mail or in person at the City offices. Applications will be
reviewed and a permit will be issued within two working days.
2. Permit cards will be sent by return mail after a review is completed. PERMITS ARE NOT
VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE
PERMIT CARD IS POSTED ON THE JOB SITE.
3. Plumbing permits may be issued ONLY to licensed plumbing contractors and to property owners
residing in the dwelling.
4. When any new construction or remodeling is involved,a separate building permit must be
obtained.
5. All wo'k must be done in accordance with State Code requirements.
6. All wo k must be inspected and air tested before it is covered. Call(952)249-4600.
(24-48 hour notice required)
TYPE 9F PERMIT
(Check All That Apply)
R dential ❑Commercial(Approval Required)
Ne ❑Additional 0 Repairs ❑Replace
0 In Acces ry Structure?
*You will need prior approval and may neer!
QUI.(Per Orono City Code,Chapter 78,Article IV)
Job Site/Owner Information:
SiteAIdress; 4101 v- Sln
.M0( cor� im.Qrtv
1
Owner: V.01h\ ►1 120V'10.yv Mailing Address:
City: , zip: 35 3 64
Home Phone 95d - 353 - 43$) Alternate Phone:
Contractor Ieformation:
Contractor: Contact Person:
LIGAN %IA ai.GONU,I H I ONING
Addds%�3) CULI. GAN WAY State Bond#:
ut,
MINIVETi0 ,
City: (952) 933-72°0 Zip: Expiration Date: QJ rti
Phone: Alternate Phone: ' 5 - 1► .- 7311
0 Insurance—Current:
1
02/22/2011 1123 FAX 9529\335049 CULLIGAN MNTKA e003
Sari si[K��'� ,C �:�*' �� %'!"t� *R �rr£.a-�'i'J'�'�',',"r�j'f'�.�r�r ti. �ti ��,yr
'+l�-�+.I N l + ,r�b,! . G is n � I.r 1!.1�. `.03 .,�:.!�.�+:.: .� n�a:L'1.,,,." ,i�.; f.::' �7 1
FIXTURE BSMT IsT 2N° OTHER FIXTURE BSMT 1sT 2''1D OTHER
TYPE FL FL TYPE FL FL
Water Closet Floor Drains
Lavatory Sewer Ejector
Batljtub Laundry Tray
Shoyl ver Washer
Kitchen Sink I Water Heater
Disposal I Water Softener I
Dishwasher Wet Bar
Sillocks Miscellaneous
•
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"�'`�'�ir.:a ti;��'-e�S� 'k.�;N�t'iiu�?''� "�*�,.a 1s�t7a�dMv' +�.....€fit 1„,� ,.»'��1`:.�: X; ,ti J 3� r.. r.�'kh1.t. wC$^,., ,.,1#1ti'Aiiz4`
,\ Yes,this section applies
i I
The replacement of a Jtesidential fixture or fioplian4e that meets all three of the following requirements:
I
1. Does not require modification to electrical or gas service.
2. Hiss a total cost of$500.00 or less;ex luding the cost of the fixture or appliance:and
3. Is improved,installed or replaced by t e homeowner or licensed contractor.
S up next section,if this applies; Cost of Permit $ 15.00
State Surcharge $ 5.00
Mail-In Fee(If Applicable) $ 2.00
Total Permit Fee S
(Permit Fees Continued On Next Page)
2
02/22/2011 12:23 FAX 9520335049 CULL MINTKA IJ004
r:0 j�-F,S ,4712Ti ti#� ^ ' i f t 77 C� '157 7,
I Y '( T�6- " ��r i u!'. G17 .
If above does t apply;follow guidelines below:
1. i NTRACT PRICE *is 1.25%of contract price with a(Minimum Fee of$50.00)
x.0125$
(contract price) (minimum$50.00)
2. S ATE SURCHARGE **Add the state Bldg Code Div.Surcharge(Minimum Fee of$5.00)
x.0005 $
(contract price) (minimum S 5.00)
3. P e TAGE&HANDLING(Only on Mail-In Applications) $ 2.00'
I �
4. i I AL PERMIT FEE(Add Lines 1-3 Above) $ a.vv
• • CO ' CT PRICE or JOB COST means the actual or estimated dollar amount charged for the
permitted ork including materials,labor,profit,and other fixed costs. It is the amount to be charged
to the cu mer for the work done. If any material,equipment,labor or installations are furnished by
the owner nant or any other party,the reasonable market value of such items must be added to the
estimated or contract price for permit fee purposes. In the event that there is a dispute on the
amount o I e job cost, the City may request the submission of a signed copy of the actual contract.
• **The S I TE SURCHARGE is.0005,of the contract price under$1,000,000 or$5.00—whichever is
greater. F valuations over$1,000,000 call the Building Department at(952)249-4600 for the price.
!.
e undersi ed hereby aPlies to the City fQr issuance of a Plumbing Permit, agrees to do all
rk in stri• accordance with the ordinances of the City and the regulations of the State of
innesota, d certifies that all statements trade on this application are complete, true and
correct.
Applicant's nature: ae: - l
Date:g � ' �
i I .
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