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 Instructions <br /> '_. �ou ::Z�y apply ror plumbinc permits by r.;ail or in person at ,:he City of.fices. <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 recPived. <br /> 3. Pe�-mits are not valid until you receive a permit card. <br /> �. 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 r_ew construction or remodeling is involv�d, a separate building permit must <br /> be obtained. <br /> . 7. All aork must be done in accordance with State Code requirement � `.`::^�"�:� <br /> �n r',R <br /> 8. AlI work must be inspected before it is covered. Call 473-7357.� <br /> 24 honr notice reqnired. <br /> *****************�t********************************************************* <br /> JOB SITE ADDRESS: �/�D Cv �� � <br /> Occupancy Type: �( Residential Commercial <br /> OWNER'S NAME: �/�UC. �f�1'l��/�S Phone No. : r �� �S ?�/ <br /> ::ailir.g Address: City: Lo�'�-L ��E <br /> CONTRACTOR'S NAME: �U��Zj ✓�. ���LC, Bus. No. : �1�25'�yy1/ <br /> Mailing Address: ](v/ v:t ni(� S�, � City: $, L,J'? Zip: 5�/ <br /> Master Plumber' s State License No. : City Cert. No. : <br /> *************************************************************************** <br /> • � � PLUMBING FIXTIIRE SCHEDULE <br /> , (Show number of fixtures of each type on each floor) <br /> FIXTURE TYPE BSMT 1ST FLOOR 2ND FLOOR OTfiER FIXTURE TYPE BSMT 1ST FLOOR 2ND FLOOR OTHER <br /> ------------- -- -- �----_ ---T----- ------ -----------__ ---- ----�---- -----r----- <br /> - - <br /> 6:ater Closet � Sewer E ector � <br /> -------------1---- ---—--- ---- ---- ------ -------]--- --- ---•---- ---------�----- <br /> � <br /> Lavatory � ; --- ---- j------ Laundry_Tray- ---- --- ----- ---------� <br /> _ -------------i---- '----- �- ----� L----- <br /> Bathtub i j �- washer _--_---_' <br /> -------------1----- ------- - --- ------i------------- �----�-------- - � ----- <br /> I , <br /> Shower ---_--y__-__; �_ ihater Heater �_ _-______ <br />" � ------- � ^--•----- ------ ------ ------ � <br /> ------- --- --�----- - ^----- <br /> Ritchen Sink ; ____; Water Softner�� I ____----� <br /> _ - _______________ �__.____ _______�______I_____________1____1___.____ _ _____ <br /> Disposal � � � Wet Bar �, <br /> � <br /> -------------1-----�------ ------- ------ ------------- ---- ---•---- - �----- <br /> i --------�. <br /> Dishwasher � � Sump Pump <br /> -------------1I-----L---- -- ------ ----- ------------ -- ------- --------- �----- <br /> --�lcccks--- + ----�---•-- ------- ---- Misc�-(List� -- ----- --------- I ----- <br /> Floor Drains <br /> _____________ _____1___�____ _________ ______ _____________ ____ ________ __________ _____ <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 /> 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 /> *************************************************************************** <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 />�e <br />