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CITY OF ORONO APPLICATION FOR PI,UMBING PERMIT <br /> � Box 6 6 (13 3 5 So Brown Rd) _ -----�- <br /> Crystal Bay, MN 55323 r�-`'f r^�,��^ <br /> ********************************************************************* <br /> General Instractions �1 � \`"� "�� `� <br /> 1. You may apply for plumbinq permita by mail or in person at the City officea. <br /> 2. Mailed in applicationa 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,r-- � <br /> 3. Peraits are not valid until pon receive a persit card. <br /> 4. Work must not beqin unless the permit card is available on the job s�,�t[e�', 2 2 ,�§.�92 <br /> 5. Plumbing permita may be isaued to licensed contractors only. <br /> 6. When any new conatruction or remodeling is involved, a separate buildinq permit must <br /> be obtained. <br /> 7. All work muat be done in accordance with State Code requirementa. <br /> 8. All work must be inspected before it is covered. Call 473-7357. <br /> 24 honr notice reqnired. <br /> ******************************************n********************************* <br /> JOB SITB ADDRBSS: �7S j�u/�E2i Ca/�-L/ �1'� <br /> Occupancy Type: cl Resic�ential Commercial <br /> OWNER'S NAME: Phone No. : <br /> Mailing Address: City: <br /> CONTRACTOR'S NAME: � -1 ;� ' ,, �� v� Bu s. o. : �(o(o�,�n; 7 <br /> Mailing Address: t' -� �', City: i�d � Zipe�S /�,z� <br /> Master Plumber's State License No. : ��-� City Cert. No. : <br /> ****************************************** * ****************************** <br /> PLUMBING FIXTIIRB SCHEDUI,$ <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 /> � ------------- ---- ----+----- ---T----- ------ ------------ ---- ---^�---- --------- ----- � <br /> Water Closet � Sewer Ejector <br /> LavatorY----- -�-- ------ --------- ------ Laundry_TraY- ---- ---•----- -------- ----- <br /> Bathtub -____ Washer <br /> ------------ -�- ----- - -- ----------- -- --^----- --------- ----- <br /> Shower Water Heater <br /> Ritchen Sink Water Softner <br /> Disposal---- --- ---- ----- ---- Wet_Bar----- -�- --•---- --------- ----- <br /> Dishwasher---l---- ---•-- ---- -- ---- Sump-P�p---- --- ---------- ----- <br /> - - - - - - - - - - ��:,,� <br /> Sillcocka--- --- --•-- ------- ---- Misc�_(List)- --�- ���� ---------- ----- <br /> Floor Drains <br /> ------------- --- ---�--- -------- ------ ----------- --- -------- ---------- ----- <br /> *************************************************************************** <br /> 1. Fixtnre Fee The minimum permit 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 � Handlinq (Only mail-in applications) $ 1.50 <br /> 4. TOTAL PBRMIT FSE (add lines 1-3 above) $ <br /> *************************************************************************** <br /> The undersigned hereby applies to the City of Orono for issuance of a Plumbing Permit, <br /> aqreea to do all work in atrict accordance with the ordinancea of the City and the <br /> regulationa of the State of Minnesota, and certifies that all statements made on this <br /> application are complete, true and or ect. <br /> Signature of Applicant: Date: <br />