HomeMy WebLinkAbout2010-01123 - water softner � � CITY OF ORONO PERMIT NO.: 2oiaoii23
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISsuEv: l U17/2010
952 249-4600 FAX: 952 249-4616
ADDRESS : 915 PARTENWOOD RD
PIN : 08-117-23-21-0011
LEGAL DESC : PARTENWOOD
: LOT 002 BLOCK 003
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
SAFAR,MARY
925 PARTENWOOD RD
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 goveming 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 use.
� / / /v � � � �
Appli t Permitee Si ature Date Iss By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
11/16/2010 15:31 FAX 9529335049 CULLIGAN ffi�iTKA f�002
FO�C1 IJSE ONLY
4'�"�` P Box Orono Dace Receive/d/�� / V Permit q �/� ��1.�
� � 2750 Kelley Parkway
;. L Crystal Bay,MN 55323 Approved By: Amount S: ��
����� (952)249-4600
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CITY OF ORONO—PLUMBING PERMIT
(nli Commercisl permics muat be approved by the Huifding Oflicial or Inspeccor)
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 retum mail after a rcview is completed. PERMITS ARE NOT
VALID UNT[L YOU RECENE A PERMIT. WORK MUST NOT BEGIN UNTIL THE
PERMIT CARD IS POSTED ON THE JOS SITE
3. Plumbing permits may be issued ONLY to licensed plumbing contractors and to property ov►mers
residing in the dwelling.
4. When any new construction or remodeling is involved,a separate building pertnit 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 coverod. Call(952)249-4600.
(?A-48 hour notice required)
TYPE OF PERNIIT
Check All That A 1
�Residential ❑Commercial(Approval Requirec�
'�Ll New ❑Additional ❑Repairs ❑Replace
7�
❑ In Accessory Structure?
*You will need orior anuroval and may need CUP,(Per Orono Ciry Code,Chapter 78,Article(V)
Job Site/Owner Information:
Site Address: 915 PAt ��,r�„�oo� I��w�
Owner: �1ara Sa�C a�' Mailing Address:
city: zip: �535(e
Home Phone: 95�.�ll l - `�a`14 Alternate Phone:
Contractor Information:
, C n ra �Qr�: . Contact Person: �.
�U��-��"��WpT ND�TIONING
CULLIGAN WAY State Bond#:
181 TON , 345
City:
(S�a2) 933-7200 Zip: Expiration Date:
Phone: Alternate Phone: 950�- `jJ,�,- 7 3 I'7
❑ Insurance—Current:
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11/16/2010 15:31 FAX 9529335049 CULLIGAN MNTKA C�003
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FIX7'IJRE BSMT 1 2 OTHER FIXTURE BSMT 1 2 OTHER
TYPE FL FL TYPE FL FL
Water Closet Floor Drains
Lavatory 5cwer Ejector
Bathtub Laundry Tcay
Shower Washer
Kitchen Sink Water Heater
Disposal Water Softener
Dishwasher Wet Ber
Silicocks Miscellaneous
tl .�,
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� Yes,this section applies
.��
The replacement of a Residential fixture or a� I,q,i��that meets all threc of the foliowing roquirements:
1. D es require modification to electrical or gas service.
2. Has a total cost of$500.00 or less;gxcludin¢the cost of the fixture or appliance:and
3. Is improved,instailed or replaced by the homeowner or licensed contractor.
Skip next section;if this applies; Cost of Permit S 15.00
State Surcharge $ 5.00
Mail•ln Fee(If Applicable) $ 2.00
Total Permit Fee S
(Permit Fees Cootinued Oa Next Page)
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11/16/2010 15:31 FAX 9529335049 CULLIGAN MNTKA f�004
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ri;;'�;. ��, � ��� �� T C� `'�' ':-� ,5`; ��►,'�.v �. :r�'.;�;i,�,,:
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If above does not apply;follow guidelines below:
1. CONTRACT PRICE '�is 1.25%of contract price with a(Mini um Fce of 550.00)
x.O1Z5$
(contract price) inimum$50.00)
2. STA'I'E SURCHARGE "*Add the State Bldg Code Div.Surcharge(Minim Fa of S5.0o)
x.0005 S
(wnuact price) (minimum$ S.
3. POSTAG�&HANDLING(Only on Mail-In Applications) S Z.
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) S � � �V
■ " CONTRAC'f 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 W be charged
to the customer for the work done. 1f any material, equipment,labor or installations are fumished 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,
■ **The STATE SURCHARGE is.0005 of the contract prica under�1,000,000 or��:�Ot�—whichever is
grester. For valuations over$1,000,004 call the Building Departrnent at(952)249-4600 for the price.
The undersigned hereby applies to tho City for issuance of a Plurnbing 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
correc�
Applicant's Signahue: Date: � �' �b' ��
3