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08/18/2004 09:19 FA% 763 591 6071 IVERSON ��8y 9 l�004 <br /> .. �- .�.. , <br /> � r , � 93.�O` ' <br /> CTTY OF ORONO APPLICATION FOR PLUI�ING PERMIT <br /> Box 66 (2750 Kelley Parkway) <br /> Crystai Bay, MN 55323 <br /> rENERAi.II�iFORMATION <br /> 1. � You may apply for plumbing permits by mail or in persoa at the City offices. � <br /> Z. Permit cards will be sent by return mail after a review is completed. PERMITS ARE NOT VALID UNTIL ' <br /> YOU RECENE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIIT CARD IS POSTED ON <br /> �'�E JO� SITE. <br /> 3. Plumbiag permits may be issued ONLY to licensed plumbing contractors and to property owners residing <br /> ia the dwelling. <br /> 4. When aay new coastructioa or remodeling is iavolved, a separate building permit must be obtair�ed. . <br /> S. All work must be done in accordance with the State Code requirements. <br /> !6. AII work must be inspected and air tested before it is covered. Call (952) 249�600. 24-hour notice <br /> required. <br /> Instructions Complete all items on this applicarion. Compute the permit fee. Sign and date the <br /> �ertification. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have <br /> �questions, call (952) 249-4600. <br /> Please check one: �New Addition Repair Replace <br /> Residential Commercial <br /> JOB SITE: �.. c Zip: � <br /> Owner's Name: o � ����.�cc Nar►�e�, Telephone Number: . <br /> Mailing Address: City: Zip: <br /> Cou�ractor's Name: 't'1�cEr� Pl v�-.l���� � �,� Telephone Number: �i SZ-��y S'3� <br /> Mailing Address: ?-io[� C��v: �2 City:_p�,y,,x,� Zip: S'9./�{/ <br /> PLiTMBING FIXTURE SCHEDUI,E <br /> . FIXTURE B5MT 1ST 2ND OTHER FIXTURE BSMT 1ST 2ND OTH�R <br /> TYPE FL FL TYPE FL FL� <br /> Water Closet � Floor Drains � <br /> Lavato � � Sewer E'ector <br /> Bathtub � � Laun Tra <br /> Shower Washer � <br /> Kitchen Sink ! Watec Heater � <br /> D' sal � water Softener <br /> Dishwasher Wet Bar I • <br /> Sillcucks Misc liat <br />