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� <br /> " CITY OF ORONO APPLICATION FOR 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 peraon at the City officea. <br /> 2. Mailed in applications are subject to the postage and hanclling fees shown below. <br /> Permit cards will be sent by return mail the same day the app].ication 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, ei� n � '1,�9 ' <br /> 6. When any new construction or remodeling is involved, a separate ��L�3i�g 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 hour notice reqnired. <br /> **********************************************,t**************************** <br /> JOB SITE ADDRESS: . '�'�� ���-f�'��� �� ���1 � <br /> Occupancy Type: x Residentia Commercial <br /> TT- <br /> ,- , <br /> OWNER'S N�: �� � �;.�� Phone rro. : �t-7(- ���S��" <br /> Mailing Address: �;�> ���„�,-�,�i �' `� City: ��.�;�-Z-; <br /> CONTRACTOR'S NAME: �'.{,�����;�; Bus. No. : <br /> Mailing Address: ��_ -;`_ � ;.�i�� c��� City: ��;�,��. , Zip: .�� <br /> Master Plumber's State License No. : 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 OTAER <br /> ------------- ---- ----+----- ---T----- ------ ------------- ---- ----�---- --------- ----- <br /> Water Closet �_ Sewer E ector <br /> ------------- --- -------- ---- --- ---- ------]---- -- --•---- ------- ---- <br /> Lavatory Laundry Tray <br /> ------------- ---- ------- -------- ------ ------------- ---- ---�----- --------- ----- <br /> Bathtub Washer <br /> ------------- -----�------- ----- ---- ----------- -- --^---- ------- ---- <br /> , <br /> - - - - - - - - - - - - - - <br /> Shower Water Heater <br /> Kitchen Sink I -__-__ Water Softner - <br /> -------------{----- --�----- ---�---- ----------- -- -------- --- ----- ---- <br /> Disposal I_ __--__ Wet Bar <br /> -------------•1 --- ---- ----- --------- -- --�---- -------- ---- <br /> Dishwasher Sump Pump <br /> Sillcocks Misc. (List) <br /> Floor Drains <br /> ------------- ----- ---�---- --------- ------1-------------1---- -------- ---------- - <br /> *****************************************************************�******** <br /> r� a�; <br /> 1. Fixture Fee The minimum permit fee is $30.00 $ �, <br /> Compute number of fixtures � x $5/fixture <br /> x $3/fixture reset <br /> 2. State Surcharge $ .50 <br /> � 3. Postage & Handling (Only mail-in applications) $ 1.50 <br /> � r C�:. <br /> 4. TOTAL PERMIT FEE (add lines 1-3 above) $ .�,J�-a� — <br /> *************************************************************************** <br /> The undersigned hereby applies to the City of Orono for issuanae 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 certffies that all statements made on this <br /> application are complete, true and correct. <br /> Signature of A�plicant:�� �� �'�-��z��-�'(��-L--- Date: /�'� � -�� � <br /> � CULL��rAN WATER COND1T10NING <br /> � . �,. <br />� ,� �:;: ;�� , <br />