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�`��/� <br /> •• CITY OF ORONO APPLICATION FOR. PLUMBING PBRMIT <br /> 1 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 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 muat 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 muat 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 required. <br /> **********************.x���***************,,**�****�* ************************ <br /> . JOB SITE ADDRESS: �� �C� /'U��,'�/�i,rk. . <br /> Occupancy Type: Residential Commercial <br /> OWNER'S NAME: o ��y����.�_� Phone No. : y 7� � ��� <br /> Mailing Address: � �/�'� �� � t� � City: _��;,,� <br /> CONTRACTOR'S NAME: _ , �µ !I , � � � � . Bu s. No. : ���-��15� <br /> Mailing Address: - � . City: �,�1,���„� Zip: �</�y <br /> Master Plumber's State License No. : 5`V City Cert. No. : <br /> *************************************************************************** <br /> PLUMBING FIXTURE SCHEDULE <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 /> ------------- ---- ----a----- ----r----- ------ ------------ ---- --------- --------- ----- <br /> Water Closet J � _-___ Sewer Ejector <br /> ------------ ---- ---�•---- --- --- ----------- -- --�---- ------- ---- <br /> Lavatory / / Laundry Tray J <br /> / � <br /> Bathtub - ] � _-_--_ Washer <br /> ------------ --- - -�-- ---- ----------- -- ------ ------- ---- <br /> Shower Water Heater l <br /> Ritchen Sink � � Water Softner <br /> -------------+---- --�----- ---�---- ------ ----------- ---- ---�----- --------- ---- <br /> Disposal I- _--__ Wet Bar <br /> -------------1 --- ---- ----- ---------- -- --�---- -------- ---- <br /> Dishwasher (- -_ Sump Pump <br /> ------------ •1 ---- ---- --- -------- --- ----------- -- ----- -------- ---- <br /> Sillcocks � Misc. (List1 <br /> Floor Drains <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 /> 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 /> **************************************************,t************************ <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 certifiea that all statements made on this <br /> application are complete, true and correct. <br /> Signature of A�;plicant: Date: � <br /> ,-�. - -; <br /> �t ii'. +; <br /> -s�` � �_. � <br />