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Home My WebLink About1985-8194 - plumbing GE�I�ERAL PERMIT CITYPERMITNa 8194 C�TY OF ORONO / Q P.O.BOX 66 ' Date_ I 1� � ` U�� CRYSTAL BAY,MINNESOTA 55323 ' (612)473-7357 Owner � ��y �ro�Q-� ��i�ddress_ `� /S Qx�l�/ �� Contractor -� � � � 0�- �?�ddress C�1�7 / ��Gt �Q ��• �, City License No. State License No. ��C1 M i v1� l�� REMARKS AND SPECIAL CONDITIONS �y� PERMIT TYPE AND FEE: ❑ NEW ❑ ADDITION ❑REPAIR Inside Plumbing(#fixture�� Fee $ �'�� Water Well Fee $ Water Meter(Size_) Fee $ Mechanical Equipment Fee $ Meter# Remote# Moving/Lifting Buildings Fee $ Municipal Water Connection Fee $ Land Alteration (Excavation, Fee $ � Grading, Filling, etc.) ❑Copper Municipal Sewer Connection Fee $ Fire Fee $ ❑ PVC ❑Cast � Sprinkler System (Fire) Fee $ MWCC SAC Charge Fee $ Other: �I�,�.G/�� Fee $ ' � On Site Septic System Fee $ After-the-fact Investigation Fee $ ACKNOWLEDGEMENT TOTAL The under�gned hereby ackaowledaes receipt of this limited permit, including acceDtience of ell special informatton, tem►s, conditions or requirements wxitten above. The ,�tate Surcharge: Fee $ •�� undersigned underatands and aarees undex penalty of law that this Hermit is atrlctlY 1in►ited in scoDe to the work, �� '� activitq or imDrovement sDecifled; that this permit dces not grant anY authorlty to do wozk or activities reauiring Total Amount Paid to City Fee $ separate permit aBProvals; and that this permit does not �ant authorlty to violate any Drovision of �ny City ordinance or State law,xule or regulation.All work sheII be done in strlct compliance with all City ordiaances,building codes aad/or health devartment reQulattona, and shell be 'This permit is not valid until the proper fee is paid and sublect to inaDection, �proval or reiection by the c�ty. it is approved by an authorized City Official. Whenever so ordered, the undersigned a�eea to correct any work found to be in violation of the condttions of this pertnit. Signature of Applicant Signature of City Official . M c�P. �� . Code:White—File Copy Canary—Inspector's Copy Pink—Finance Copy Gold—Applicant's Receipt ... ......�. �._.... _ . . � . ...� �...�_....�....v .. ._�..�_�.... P. Box 66 (1335 Brown Road South ) Crystal Bay, MN 55323 ************************************************************************** General Information 1. You may apply for plumbing permits by mail or in person at the City offices. 2. Mailed in application are subject to the postage and handling fees shown below. Permit Cards will be sent by return mail the same day the application is received. 3. Permits are not valid until you receive a permit card. 4, work muat not begin until the permit card is poated on the job site. I 5. Plumbing permits may be issued tostate-licensed plumbers or to homeowner/occupants who intend to ' actually perform their own work in their home. ° ' 6. When any new construction or remodeling is involved, a separate building permit mu�� be ob�a�ined. � 7. All work must be done in accordance with the State Building Code Requi�ement�'a. , 8. All work must be inspected before it is covered. Call for inspectionst7,?1 hours in advance `� (473-7357). , •f � �� Instructions. Complete all items on this application. Compute the permit'f�§�.e S�a� �a�l.+`�t[e j ', I}� certification. Incomplete applications will not be processed. Zf you has�':any questions, call , Y� 473-�357. . � .;;� ' WALK-IN PERMITS--Apply at City Offices, 1335 Brown Road So. (County Rd 146)" � � '; � E' Y�� MAIL-ZN PERMITS--Enclose Fee--Mail to: P.O. Box 66, Crystal Bay, MN 55323 " " ******�k*****�F*******�k***************�r***********�k*�ctt*�Ir*******ak****�Ir***ek*** JOB SITE ADDRESS 475 Oxf ord Road Occupancy Type: X Residential Commercial Work to be Performed by: Licensed Contractor Owner/Occupant OWNER'S NAME M. F. Schroeder Const. Telephone No. 566-511.4 Mailing Address 3324 - 75th Avenue No., Brookl.yn Park, MN 55443 PLUMBER'S COMPANY NAME Welter & Blaylock, Inc. Business No. 881-3171 Mailing Address t5657 Lyndale Ave. So., Bloomington� MN 55420 Master Plumber ' s State License No. 257 City Cert. No. 28274 ************************************************************************** PLIIMBING FIXTURE SCHEDOL$ (Show Number of Fixtures of Each Type on Each Floor ) FSXTURE YYPE BSMT. Lst Floor 2nd Floor � Other Floors FIXTURE TYPE BSA±T. lst Floor 2nd Floor Other Floors Water Closet 1 3 Laundr�Tra Lavatorv ], i:asher Bathtub �7�' 2 «ater 'cieater Shower 1 1 Water Softner � Kitchen Sink l 4isc. Fixtures: I Dis�osal _ � (List) ��-- Disiwas`er �l ; -- — - wet Bar Sillcocks FLoor Drains I Sum PumD � Sewer Eiector � TOTAL vUMBER OF FIXTUR£S � *7k*7k***7k*7k71t7k*7k*****�1c7k�t7Y7k*�c*****7k*�k*********�k***7k*7k7k*7k*7k******'********�k�lc*7t* PERMIT FEE CALCULATION 1. Fixture Fee. The minimum permit fee is $25. 00 . Compute number of fixtures 24 x $4/fixture $ 96.00 2. State Surcharge $ . 50 3. Postage and Handling (Only for Mail-in applications ) $ 1. 50 4. TOTAL Permit Fee (Add lines 1-3 above ) $ 98.00 ************************************************************************** The undersigned hereby applies to the City of Orono 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 Minnesota State � Building Code, and certifies that all statements made on this application are complete, true and correct. % � ,, . ��,� _ = 11/14/85 � Signature of Applicant Date � DA� TIME CITY OF ORONO CALLED IN � INSPECTION NOTiCE SCHEDULED � e� — �f-� PERMIT NO. COMPLETED � `� �' � ADDRESS �7� � OWNER CONTR. TELEPHONE NO. - ❑ FOOTING �PLUMBING RI O SITE INSPECTION ❑ FRAMING ��P�UMBING FINAL . O EXCAV✓GRADING/FILLING j; ❑ INSULATION ❑ MECHANICA� ❑ LAKESHORE/WETLANDS I� ❑ WALL BD. ❑ WATER HOOKUP ❑ LICENSING � ❑ FINAI ❑ METEfi SET/TURN ON ❑ COMPLAINT Q ❑ PROGRESS ❑ SEWER HOOKUP ❑ FOLLOW-UP � ❑ DE�vIOt. ❑ SEPTIC INSTALL. ❑ SEPTIC FINAI Q ❑ FIRE PREV. ❑ SEPTIC MAINT. ❑ FIREPLACE/WOOD BURNER Z ❑ WELL TEST PUMP ❑ ____ _ � COMMENTS: � ,, � g�-65 . 2 l.� h��/� W _ J z � �� 0 � � w � � J O � 2 O � W � Q � Z W � W � � d W � W ORK SATISFACTORY:PROCEED ❑ PHOTO TAKEN p ❑ CORRECT WORK&PROCEED U ❑ CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING ❑ CORRECT UNSAFE CONDITION WITHIN HOURS.INSPECTOR WILL RETURN. ❑ STOP ORDER POSTED.CAIL INSPECTOR. ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. call for the next inspection 24 hours in advance._ Owner/Contr. on site I nspector� 473'1357 White Copy/Inspector's File Gold Copy/Site Notice