Laserfiche WebLink
� <br /> CITY OF ORONO APPLICATION FOR PLUMBING PERMIT <br /> Box 66 (1335 So Brown Rd) <br /> Crystal Bay, MN 55323 � ��� �, <br /> � � �************************************************************************* <br />� General Znstrnctions <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. Permi.ts 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 invol ved, a separate building permit must <br /> be obtained. <br /> •- 7. All work must be done in accordance with State Code requirements. <br /> 8. AlI work must be inspected before it is covered. Call 473-7357. <br /> 24 honr notice reqnired. <br /> *************************************************************************** <br /> JOB SITE ADDRESS: <br /> Occupancy Type: X Residential Commercial <br /> � <br /> OWNER'S NAME: ��C � C� �� Phone No. : <br /> Mailing Address: �;ofp, ' �!l,p , City: ���y� d <br /> CONTRACTOR'S NAME: C � � �)v�b�v�� Bu s. No. : ���]3���� � <br /> Mailing Address: , City: L-.; L._, � Zip: at'�;.�%� <br /> Master Plumber' s State License No. : �`�� � City Cert. No. : <br /> *************************************************************************** <br /> � ° PLUMBING FIXTURE SCHEDULE <br /> l (Show number of fixtures of each ty�e on each floor) <br /> FIXTURE TYPE BSMT 1ST FLOOR 2ND FLOOR OTHER FIXTURE TYPE BSMT 1ST FLOOR 2ND FLOOR OTHER <br /> -------------' --- ---a----- ----r----- ------ -------J----- ---- ----�---- --------- ---- `, <br /> Y:ater Closet � � ' � Sewer E ector � <br /> ' , �___________�1�___y___�____ ___�'____�__�___ _____��______ �___ ___'�__�_ _________l-_____ <br /> � <br /> Lavatory � ; I ; Laundry Tray <br /> ------------- � ---�---—---- ---- ---1------ ------------- -- ---��---- ------- ---- <br /> -.. �- ; - - - -, - <br /> "- Bathtub � � �- a _____- Washer I <br /> _ --------------�----- ------- ------ ------------- ---- ---^--- ---------'r----- <br /> j � <br /> - � <br />° Shower _-_--_{-_-_- / I_ � Water Heater � � <br /> _ � ------- , � --•-----� ------ ------ ------------- ---- --�---- ---------r----- <br /> _ Ritchen Sink � j f I Water Softner � r i <br /> ------------ --- ' --•---- ---�----�----- ------------1--- --�---- -------- ----- <br /> --- - -�- - - - - - -� <br /> , ; , <br /> Disposal � ----� � ------- ------ Wet�Bar------ ---- ---•---- ---------� <br /> -------------1- L------- �----- <br /> , <br /> i - <br /> Dishwasher �I I / --_--- Sump Pump <br /> -------------1---- --- -- ------- ----------- -- ------ -------- ----- <br /> SillCocks C.� Misc. (List) <br /> ------------- ----- ---• - <br /> .� Floor Drains y �e 5 jy' /\ <br /> ------------- ----- ---�---- --------- ------ - <br /> -�--------- ---- ---�---- ---------- ----- <br /> *************************************************************************** <br /> 1. Fixture Fee The minimum Fermit fee is $30.00 $ <br />: : Compute number of fixtures x $5/fixture <br /> x $3/fixture reset <br /> y:h <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) $ <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 /> . -.. �' s �> > � �d <br /> Si nature of A licant: --�.�� Date: <br /> g FP <br /> i� <br />