HomeMy WebLinkAbout2017-00077 - water softner CITY OF ORONO �i �!1 II 1111 111
77 *
2750 KELLEY PARKWAY * 2 1 7 - 0 0 0 2
DATE ISSUED: 01/25/201717
• ORONO,MN 55356-
(95 )
5356-
(952)249-4600 FAX: (952)249-4616
ADDRESS : 285 OLD CRYSTAL BAY RD N
PIN : 33-118-23-31-0005
LEGAL DESC : UNPLATTED 33 118 23
: LOT 000 BLOCK 000
PERMIT TYPE : PLUMBING 1
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WATER SOFTENER
NOTE: REPLACING A"RENTAL"WATER SOFTI4ER
VALUATION OF PLUMBING 200
APPLICANT PLUMBING FIXTURE FEE 50.00
STATE SURCHARGE PLBG(VALUATION) 0.10
CULLIGAN SOFT WATER SERVICE CO. MAIL-IN FEE 2.00
6030 CULLIGAN WAY
MINNETONKA,MN 55345- TOTAL 52.10
(952)912-7379 Payment(s)
CREDIT CARD 5107 52.10
OWNER
MILLER,CARRIE
285 OLD CRYSTAL BAY RD N
LONG LAKE,MN 55356-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed#ccording 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 it revoked at any time for due cause. `(i 4 l
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Applicant Permitee Signature Data Issued By Signatu Date
01/24/2017 11:43 FAX 9529335049 CULLIGAN MNTKA 0 004
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CityBox 6s Received:of Orono eceiiv FORCITY USE_fON.LY, ; .:
Date_ ' _
P.O. `�: '
2750 Kelley Parkway • ; :
Permit.#.< =: .'j ::....
MN 55323 " j',
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kasHo (952) 249-4616 Fax
CITY OF ORONO — PLUMBING PERMIT
(All Commercial Permits Must be Approved by the State Prior to City Approval)
http://www.dli.mn.govICCLD/PDFIpe plumbpianrevapp.pd
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fGENERAL'INFORMATION '�' . ` �`° �` °'` '' {��
1, You may apply for plumbing ermits 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
UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN tUNTed. IL RHETPERMIT S ARE 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 work must be done in accordance with State Code requirements.
6. All work must be inspected and air tested before it is covered. Call (952) 249-4600.
(24-48 hour notice required)
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E:O�;;PERM1.:..
Residential ❑ Commercial (Approval Required) [Backflow Device:D AVB ❑PVB]
E Additional El Repairs
Replace
[1 New
❑ In Accessory Structure?
*You will need prior approval and may need CUP. (Per Orono City Code, Chapter 78, Article IV)
Tiitc:Tritiation:
Site Address: a hCr-LiRo-,/
Owner: C 6,4/Vt./ m Mailing Address:
City: Zip:
Home Phone: 9S'1,- a-01 L 3 Alternate Phone:
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ontrac0 information;;•14:V °f`' ';'v�>:,;�ir` '':i 7:
Contractor: Contact Person:
`LILLIGAN WATER CONDITIONING State Bond #:
Address: 6030 CULLIGAN WAY
MINNETONKA, MN 55345 Expiration Date:
City: (952) 933-7'04 Zip:
Phone: Alternate Phone:-
❑ Insurance — Current:
Page 1
01/24/2017 11:43 FAX 9529335049 CULLIGAN MNTKA 1005
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ING`FiXTIJR � ._ _ ��
E$r'BEIN�::INScT�...� -C � . �:� Ztetd
FIXTURE BSMT 1ST 2ND OTHER FIXTURE BSMT 1ST 2ND Floor Floor OTHER
TYPE Floor Floor TYPE
Water Closet Floor Drains
Lavatory Sewer Ejector
Bathtub Laundry Tray
Shower Washer
Kitchen Sink Water Heater
Disposal Water Softener I
Dishwasher Wet Bar
Sillcocks Miscellaneous
�-,-- n 3 � 'M� ;,� x� � .Zg PERMITTEE�ALCUEA;T1.ONA r ..... .{. ..:k . . _ .
VFI
-fix.k-.� .�._. .�..,-. ..i� : _..,.. �
1. CONTRACT PRICE * is 1.25% of contract price with a (Minimum Fee of$50.00) ,
,-7-u'6 x .0125 $ "-t„
(contract price) (minimum $50.00)
2. STATE SURCHARGE
l
x .0005 $
(contract price)
3. POSTAGE& HANDLING (Only on Mail-In Applications) $ 2.00
I _
4. TOTAL PERMIT FEE (Add Lines 1-3 Above) $ 9 J
* CONTRACT PRICE or JOB COST means the actual 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, labor or installations are furnished by the
owner, tenant or 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 that 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.
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The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do all 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 application are complete,true and correct.
Applicant's Signature: L..._Q., r
Date: i-cDM `-171
Building Official/Inspector: Date:
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