HomeMy WebLinkAbout2012-00048 - water softner f
.. CITY OF ORONO PERMIT NO.: 2012-00048
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUED: 01/19/2012
(952)249-4600 FAX: (952) 249-4616
ADDRESS : 1200 ORONO OAKS DR
PIN : 35-118-23-34-0020
LEGAL DESC : ORONO OAKS
: LOT MB BLOCK 001
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
JENNINGS-TOLCHINER,BARBARA
1200 ORONO OAKS DRIVE
LONG LAKE,MN 55356-
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 ca se.
/ /91 /�--- 074/teut_ 11
Applicant Fe tteeSi re Date Issued Signature Date /
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
01/1/2012_14:29 FAX 9529335049 CULLIGAN MNTKA fji002
FORM
City of Orono
� `YO P.O.Box 66 Date Received: errnrt# ,,W1'I:0
2750 Kelley Parkway nn''
i. Crystal Bay,MN 55323 Approved By: Amount S:.
,.„ e (952)249-4600
44,4660
CITY OF ORONO—PLUMBING PERMIT
(All Commercial permit 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 work must be done in accordance withStateCode requirements.
6. All work must be inspected and air tested before it is covered. Call(952)249-4600.
(24-48 hour notice required)
TYPE OF PERMIT ; ,': ur.,s,
(Check All That Apply)
)4Residential 0 Commercial(Approval Required)
jNew0 Additional ❑Repairs 0 Replace
0 In Accessory Structure?
*Yotyvill'red prior aaaroval and may need CUP:(Per Orono City Code,Chapter 78,Article IV)
Job.Site,/Owner Information:
Site Address JaOb O(orlr, , ()cks I)r &
'a x •
."r.•
Owner
'4"'"r"
ri ��\ Mai1`ti g Address•
City: _ . 7 Zip: Jr„�i`3k;5 c;
Home Pli?tie ` 713-S 41 d1 5 3 y " 'Alternate Phone: ,
Contractor Information:
l ,. LQ
i Contact Person:
Contractor:. � Contact
CULL! N WATERCONDITIONING' State Bond#:
�'W CULLI0AN WAY
M.IN,II�E,TONKA, MN 55345,
L CLY (952) 933 7200 Zip: Expiration Date: -
;t ;
Phone: . Alternate Phone: 9'.SS /� ; ,. la - 73
11 Insurance—Current:
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01/1Q/2012,14:29 FAX 9529335049 CULL I GAN MNTKA
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v -0.044010020.=:fNlilieVehi.474a:
FIXTURE BSMT 1sT 2N° OTHER FIXTURE BSMT 15T 214D OTHER
TYPE FL FL TYPE FL FL
Water Closet Floor Drains
Lavatory Sewer Ejector
Bathtub Laundry Tray
Shower Washer
Kitchen Sink Water Heater
Disposal '
^ Water Softener 00
Dishwasher Wet Bar
Sillcocks Miscellaneous
1,411'; 12g.
"tri, t-mf:--'• * ;Pt,' 7 Z' •••
,170: -.:1;0:4'41741kIligi41144aCi,iNlat,9.:02Pli-`0,,r1;:itJ.PW.tt.t.Vie.lvifiloific4,444,,44154VM'l
1Z) Yes,this section applies
The replacement of a Residential fixture or appliance that meets all three of the following requirements:
1. Does not require modification to electrical or gas service. -
2. Has a total cost of$500.00 or less;excluding the cost of the fixture or appliance:and,
3. Is improved,installed or replaced by the homeowner or licensed contractor.
Skip next section,if this applies; Cost of Permit $ -- 15.00 ••
State Surcharge S 5.00
Mail-In Fee(If Applicable) $ — • 2;00.
Total Permit Fee $
(Permit Fees Continued On Next Page)
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ti,,
01/19/2012 14:29 FAX 9529335049 CULLIGAN MNTRA Ij004
..'al.•.,rge a . .a ,y: X4111-.1. 41 l':1'1" moi , nirierg':
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If above does not apply;follow guidelines below:
I. CONTRACT TRICE "is 1.25%of contract price with a(Minimum Fee of$50.00)
x.0125$
(contract price) (minimum$50.00)
2. STATE SURCHARGE **Add the State Bldg Code Div.Surcharge(Minimum Fee of$5.00)
x.0005 $
(contract price) (minimum$ 5.00)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 2.0Q
4. TOTAL PERMIT FEE(Add Lines 1-3 Above)
G iiO4
• * 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 famished 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 disputa on the
___amount of the job cost,The City may request the submission of a signed copy.of the actual.contrack.
• **The STATE SURCHARGE is.0005 of the contract price under$1,000,000 or$5.00—whichever is
greater. For valuations over$1,000,000 call the Building Department at(952)249-4600 for the price.
t iia9k'1I, �ITT.•.`;.; 1
f„?
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: Aziati
Date: oa
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