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CITY OF ORONO 4 +�` 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 mail or in person at the City offices. <br /> 2. Mailed in applications are subject to the postage and handling fees ahown 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 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 involved, a separate building permit must <br /> be obtained. <br /> 7. All work muat be done in accordance with State Code requirements. <br /> 6. All work must be inspected before it is covered. Call 473-7357. ` <br /> 24 honr notice reqnired. <br /> *************************************************************************** <br /> JOB SITE ADDRESS: �� / � Sf'j?uc-�-� �L � <br /> Occupancy Type: /l Residential Commercial <br /> OWNER'S NAME: Phone No. : <br /> Mailing Address: City: <br /> CONTRACTOR'S NAME: �r � ,-�; �,. ' Bus. No. : /�f � I � 7 C�y <br /> Mailing Address: ���C• �,�i � �,; �.f City: �/�<i�J`�-6- Zip: "' ���� � <br /> Master Plumber's State License No.: City Cert. No. : <br /> *************************************************************************** <br /> PLQMBING 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 �_ / � Sewer E ector <br /> ------------ ---- ---�---- --- ---- ---- ------�---- -- --•---- ------- ---- <br /> Lavatory / ____- Laundry Tray <br /> ------------- --- -'---- --��------ - ----------- -- l•---- ------- ---- <br /> Bathtub � Washer / <br /> ------------- -----�-------- ------ ----- ----------- -- ------- ------- ---- <br /> Shower / Water Heater <br /> Ritchen Sink ' Water Softner <br /> -------------�---- ------- ---•---- ------ ----------- -- ------- -------- ---- <br /> Disposal I_ � __-__ Wet Bar <br /> -------------1 --- ------ ----- --------- -- --•---- -------- ---- • <br /> Dishwasher � Sump Pump <br /> Sillcocks � Misc. (List) <br /> Floor Drains <br /> *************************************************************************** <br /> l. 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 /> *************************************************************************** <br /> The undersigned hereby applies to the City of Orono for issuance of a Plumbing Permit, <br /> agrees to do all work in s�rict 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: ��� � �•— "��` � <br /> � <br /> . . . ,}.�_. . . _ . � . � r5 . <br /> ' y�1�:� . . � . ' . . <br /> . �.. N...�. . . . .. .., ' . . . . ' .. w. . . <br />