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. � 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 maj.l 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. Permits are not valid until you receive a permit card. � ` � `' �993 <br /> ,;, nr� � 5 <br /> 4. Work must not begin unless the permit card is available on the jo"bLsite. <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 hour notice required. <br /> *************************************************************************** <br /> JOB SITE ADDRESS: �Sy-(�j (�`�: /��� �,- ��S Cg.� <br /> Occupancy Type: �Residential Commercial <br /> owr�ER�s N�: ,L,�%+..-� F4z��-L-�. Pnone rro. : �E�"3 - D.�C��-• <br /> Mailina Address: ,Sztc. C.'i�. /^:. t: Cit_y: r:,�,:.,�;-�; <br /> CONTRACTOR'S NAME: �����Z-�j Bu s. No. : <br /> Mailing Address: ;,�,.�G:> �•c�f ii��-u �L7i�-� City: ;Z�,`;j�;:r Zip: ��s�{S <br /> Master Plumber's State License No. : City Cert. No. : <br /> *************************************************************************** <br /> PLOMBING 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 /> �.____________ ____ ____I^____ ___T_____ ____.__ ________._____ ____ ____.-____ ______�__ ���.�� . <br /> Water Closet-�_ �- __--_ Sewer F.jector <br /> ------------ --- ------- ---- ---- - ----------- -- <br /> Lavatory � ' Laundry ,ray <br /> ------------- -----I---—---- -------- ------ ------------- ---- ---•----- --------- ----- <br /> Bathtub � Washer <br /> ------------ --- � ------- ----- ------ ------------ -- ------- --------- ----- <br /> Shower ! --_- Water Fleater <br /> ��_________���__�_��__'__�__ __�.�._�._ _� ___________�_ F__ ___'_____ __����_�� ��___ <br /> Ritchen Sink ' Water Softner <br /> -------------�---- -•---- ------ ---- ----------- - --�---- --------- ---- <br /> Disposal I_ wet Bar <br /> -------------1 --- ---- ----- ---- ----------- -- --•---- -------- ----- <br /> Dishwasher-_- I- Sum Pum <br /> --------- 1 ---- -------- -------- ------ ---p----p---- ---- ------- ---------- ----- <br /> Sillcocks Misc. (List) <br /> Floor Drains- ----- ---•--- --------- ----- --- <br /> . <br /> ------------ ----�---�--- ------- -----�------------ -- ------ ---------�----- <br /> *************************************************************************** <br /> ~� �r� <br /> l. Fixture Fee The minimum �ermit fee is $30.00 $ � <br /> Compute number of fixtures x $8/fixture <br /> x $5/fixture reset , <br /> 2. State Surcharge $ .50 <br /> 3. Postage b Handling (Only mail.-in applications) $ 1.50 <br /> 4. TOTAI, PERMIT FEE (add lines 1-3 above) $ �f�.- (�4' <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 rtinnesota, and certi.fies that all statements made on this <br /> application are complete, true and correct. <br /> G'`� r�_�,'�'`� °„ FR,/n��f'C�? . . T � :�'� ,. <br /> .,` � � � 1 <br /> -Z �` �� � � � <br /> Signature of A�;pli.cant.,j" r•�l � �-�'-`--- Date: ( ` � � - I 5 <br />