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.�. CITY OF ORONO APPLICATION FOIY PLUMBING PERMIT <br /> � Box 66 (1335 So Brown Rd) <br /> Crystal Bay, MN 55323 <br /> **********�**************************************************************** <br /> General Instructions <br /> 1. You may apply for plumbing permits by mail or in person at the City offices. <br /> 2. Mailed in applications are subject to the postage and handling fees shown below. <br /> Permit cards will be sent by return mail the same day the application is received. <br /> 3. Permits are not valid until you receive a permit card. <br /> 4. Work must not begin unless the permit card is available on the job site. <br />. 5. Plumbing permits may be issued to licensed contractors only. <br /> 6. When any new construction or remodeling is involved, a separate building permit must <br /> be obtained. <br /> 7. All work must be done in accordance with State Code requirements. <br /> 8. All work must be inspected before it is covered. Call 473-7357. <br /> 24 honr notice reqnired. <br /> *******************************/�******************************************** <br /> JOB SITE ADDRESS: i- / � ,-' /"s !'`: �"� /�; t�� C. ' /_- <br /> � <br /> Occupancy Type: ,�tesidential Commercial <br /> OWNER'S NAME: li,-�iD',H �-� `t C-� � T i� r'" �i-���-�� �'�'� Pholle No. : .l i i7 7 C� �.i c�� � <br /> ��Mailing Address: ,;:�7Cji=' X� r[=� ��i�� . City: �_�. ;vC^L �r /it/Uinii��� �-���j=�� �' � <br /> CONTRACTOR'S NAME: L3i�C�G�� /3/� i'L�C=, Bus. No. : � a ;r. .�'c'; � 1 : -� i <br /> Mailing Address: � _ � �;; �, 5�, City: ;�,�;�;;�,.:,�,;�� Zip: ��� ' <br /> Master Plumber's State License No. : ;", .~/y-y �r' �?^ ' City Cert. No. : <br /> *************************************************************************** <br /> PLUMBING FIXTURE SCHEDULB <br /> (Show number of fixtures of each type on each floor) <br /> FIXTURE TYPE BSMT 1ST FLOOR 2ND FLOOR OTHER FIXTURE TYPE BSMT 1ST FLOOR 2ND FLOOR OTHER <br /> ------------- ---- ----+----- ---T----- ------ ------------- ---- �---�---- --------- ----- <br /> Water Closet � Sewer Ejector <br /> Lavatory �_ Laundry Tray <br /> Bathtub � Washer � <br /> ------------- ----�------- ----- ---- ----------- -- ------ ------- ---- <br /> Shower / Water Heater j <br /> Ritchen Sink ' -__-__ Water Softner <br /> -------------�---- -/--- ---•--- ----------- -- --�---- -------- ---- <br /> Disposal I_ -_--_ Wet Bar <br /> -------------1 --- ------ ----- --------- -- --•---- -------- ---- <br /> Dishwasher I- � Sum Pum <br /> -------------1 --- —•-- ------- ---- --P----p--- -- ------ -------- ---- <br /> - --- - - - - - - - - - - - - - <br /> Sillcocks �_ � _____- Misc. (List) <br /> --- --------- ---- ---•--- --------- <br /> I ------------- ---- ------- ---------- ----- <br /> Floor Drains_1_�___L_ .� J_ _ _1____l____ �_ <br /> - -------- --�---- ---�------ ----- ----------- ---- --------- ----- <br /> ******************************rt,t**********************�r******************,t* <br /> 1. Fixture Fee The minimum permit fee is $30.00 $ � �� c , <br /> Compute number of fixtures 'i x $5/fixture <br /> x $3/fixture reset <br /> 2. State Surcharge $ .50 <br /> � 3. Postage & Handling (Only mail-in applications) $ 1.50 <br /> 4. TOTAL PERMIT FEE (add lines 1-3 above) $ �� 1,�" �� <br /> *************************************************************************** <br /> The undersigned hereby applies to the City of Orono for issuan�:e of a Plumbing Permit, <br /> agrees to do all work in strict accordance with the ordinances of the City and the <br /> regulations of the State of Minnesota, and certifies that all statements made on this <br /> � application are complete, true and correct. <br /> �O� <br /> Signature of A�plicant: `�=�-c.�i�--/=``'� Date: i / i �' 1/ <br /> , � <br /> , <br /> - � - , <br /> < � , ; <br /> � . . .:. •.�',g. <br /> .. .r,; . 4'.,.� ' �. . . � . . � . .'":' f'.i �. � <br />