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CSTY OF ORONO r�PPLSC�TION �OR PLUMBING PERMIT <br /> � , Box 66 (1335 So Brown Rd) <br /> ✓ Crystal Bay, MN 55323 <br /> � *************************************************************************** <br /> General Instrnctions <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 retLrn mail the same dal the application is received. <br /> 3. Permits are not valid �til yon receive a pezmit 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 involned, a separate buildinq permit must <br /> be obtained. <br /> . - .; 7. All work must be done in accordance with State Code requirements. <br /> • 8. Al1 work must be inspected before it is covered. Call 473-7357. <br /> 24 hovr notice reqnired. <br /> . *****,t*,t***,t**,t*****************�,*******�****** *********,t,t*************** <br /> JOB SITE ADDRESS: � <br /> . Occupancy Type: Residential Commercial <br /> OWNER'S NAI�: 5 � « �' Phone No. : '7 �� 'OJ��i <br /> � � Mailing Address: City: v o i� <br /> CONTRACTOR'S NAME: � �' Bus.._-,No. • ��� /� ` <br /> � � Mailing Address: � City: 1���'C R Zip <br /> Master Plumber's State License No. : City Cert. No. : <br /> � *************************************************************************** <br /> ' - PLIIA�IDING FIXTIIRE SCHEDUI,E <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 /> � � ------- ----�---+----- -=----- ------------- ---- --------- -------r----- <br /> ------ <br /> r _-- Sewer Ejector I <br /> S:ater Closet 1 <br /> _____________I_1_ '___�__ __ ._ I=====_ _____________ _ __ ___._____ _________ _____ <br /> � <br /> j � I- Laundry Tray �__ <br /> Lavatory � / � <br /> -------1----- -------------1 ----- ------------- ---- --- -- --------------- <br /> -------- I <br /> � � ; <br /> Bathtub I � / Washer <br /> �������������1���� ��.i���� �� ��� ������ ������������� ���� ���.�.��� ���������i����� <br /> , Shower I_ i_ I, .�_ I - Water_&eater- --/ ---•----- ---------I ----- <br /> -:�,..�� Ritchen Sink y � ; ` Water Softner � I __ <br /> -------------=-----=--��--I--------------- ------------- ---- -------- ---------� --- <br /> Disposal : --_-_ Wet Bar � � <br /> � <br /> 1-----:---�--- - ------------- ---- ---.--- --------- ----- <br /> ------------- ------- <br /> � ; <br /> Dishwasher ' S�p F�p <br /> � -------------1---- ! --L--- -------- ------ ------------- ---- ------- ---------- ----- <br /> .- Sillcocks Misc. (List) <br /> .. . ------ !-��C��p.�- - ------- ---------- ----- <br /> . �. . Floor Drains ��-nj p/{'.� -�� p� ----- <br /> ---- -/-- ----=--- --------- ------ - -------- ---------- <br /> . : ***************************************�������F�*��r ******************* <br /> 1. Fiature Fee The minimum perm�i� fee is $30.00 $ ��0��. <br /> = Compute number of fixtures vfl x $5/fixture <br /> - x $3/fixture reset <br /> 2. State Surcharqe $ .50 <br /> - � 3. Postage & Handlinq (Only mail-in applications) $ 1.50 <br /> 4. TOTAL PERIYIIT FEE (add lines 1-3 above) $ � <br /> *,t*****,t***************************�*************,t**********************�** <br /> The undersigned hereby applies to the City of Orono for issuance of a Plumbing Permit, <br /> � aqreea to do all work in atrict 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 Applicant: � � Date: � v���� <br />