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CITY OF ORONO APPLICATION FOR PLUMBING PERMIT <br /> Box 66 (1335 So Brown Rd) //,� <br /> Crystal Bay, MN 55323 `�'7��- <br /> ***********************************.***ay*********************************** <br /> General Instructions <br /> 1. You may apply for plumbing permits by mail or in person at the City officea. <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 /> *********************************�"'�*************at**�********************** <br /> JOB SITE ADDRESS: � ' >� ✓ ;, (�;,�:� C� ; � � : <br /> Occupancy Type: Residential Commercial <br /> OWNER'S NAMl3: r� ��-�U Phone No. : <br /> Mailing Address: City: <br /> CONTRACTOR'S NAME: �"' UY' �� C����'r�� �� � Bu s. No. : ���1.5 `� <br /> Mailing Address: � v� F- � S City: -� ;, d� , Zip: �.—� , c� <br /> Master Plumber's State License Na. : G� il-J City Cert. No. : <br /> ************************************ ************************************** <br /> PLUMBING FIXTURE SCHEDUL$ <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 /> --- --------- ----- <br /> Water Closet ` Sewer Ejector <br /> LavatorY----- ---- ---—---- ---- ---- ------ Laundry-Tray- ---- ---•----- --------- ----- <br /> ------------- -� -�-- ------ ---- ----------- -- --•---- ------- ---- <br /> Bathtub Washer <br /> ------------- -- --�-------- ------- ------ ------------- ---- ---^----- --------- ----- <br /> Shower _1 _ Water Aeater <br /> ------------- � - --•—�-- ------- ---- ----------- -- --•---- ------- ---- <br /> Ritchen Sink I _-_--_ Water Softner <br /> -------------+---- --•----- ---�---- ------------ ---- ------- - --- ---- _ <br /> - - - - - - --- - - <br /> Disposal _-I_ __--__ Wet Bar <br /> ----------- 1 --- ------ ----- --------- -- --�---- -------- ---- <br /> Dishwasher Sump Pump <br /> Sillcocks Misc. (List) <br /> Floor Drains- -- ---•--- --------- ------ ------------- ---- ------- ---------- ----- <br /> --- <br /> ------------- --�-- ---�---- --------- ------ ------------- ---- ----- <br /> *************************************************************************** � <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 /> ..\, <br /> 2. State Surcharge $ .50 <br /> 3. Postage & Handlinq (Only mail-in applications) $ 1.50 <br /> 4. TOTAL PERMIT FEE (add lines 1-3 above) $ <br /> *************************************************************************** <br /> The undersigned hereby applies to the City of Orono for issuance 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 /> Signature of A�plicant: Date: <br /> . �,' ,�: � <br /> . ' .l. � , � - � ' . . K'L'. . .. . . . ,_,n . . . � � . . . .... � . . . <br />