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F���z <br /> �' CITY OF ORONO APPLICATION FOR PLDMBING P13RMIT <br /> Box 66 (1335 So Brown Rd) <br /> Crystal Bay, MN 55323 <br /> *************************************************************************** <br /> General Instrnctions <br /> 1. You may apply for plumbing permita by mail or in person at the City offices. <br /> 2. Mailed in applications are subject to the postage and handling fees ehown below. � <br /> Permit cards will be sent by return mail the same day the application is received. <br /> 3. Permits are not valid nntil yon receive a peneit carS. <br /> 4. Work must not begin unless the permit card ia available on the job site. <br /> 5. Plumbing permita may be issued to licensed contractors only. <br /> 6. When any new construction or remodeling is involved, a separate buildinq 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 honr notice reqnired. <br /> ************************** *********�***** * **************************** <br /> JOB SITE ADDRESS: `7 a' � <br /> Occupancy Type: Residential Commercial <br /> OWNER'S NAM$: ��, ,���.� Phone No. : <br /> Mailing Address: S� City: <br /> CONTRACTOR'S NAP�: � Dz� Bu s. No. : Y 7�? �/� � <br /> Mailing Address: 7 70 /ow City: Zip: ,y/�� c�/ <br /> Master Plumber's State License No. : y City Cert. No. : <br /> *************************************************************************** <br /> PLUMBING FIXTURE SCHEDULS <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 OTAER <br /> ------------- ---- ---"'�----- ---T----- ------ ------------- ---- ----�---- --------- ----- <br /> Water Closet Sewer Ejector <br /> ------------- ---- ---—---- ----•---- ------ ------------- ---- ---•----- --------- ----- <br /> Lavatory / Laundry Tray <br /> ------------- ---- --—---- -------- ------ ------------- ---- ---•----- --------- ----- <br /> Bathtub � Washer <br /> --- --------- ----- <br /> Shower 1 Water Heater <br /> Ritchen Sink Water Softner <br /> Disposal Wet Bar <br /> Dishwaeher Sump Pump <br /> Sillcocks Misc. (List) <br /> Floor Drains <br /> ------------- ----- ---�=-- -------- ------ ---------- --- -------- ---------- ----- <br /> ***************#*********************************************************** � <br /> 1. Fiature 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 � Handling (Only mail-in applications) $ 1.50 <br /> 4. TOTAL Pffi2l�IIT FSE (add lines 1-3 above) $ <br /> *****************************************************************�t********* <br /> The nndersigned hereby applies to the City of Orono for isauance of a Plumbing Permit, <br /> agreea to do all work in strict accordance with the ordinances of the City and the <br /> requlatione of the State of Minnesota, and certifies that all statements maae on this <br /> application are complete, true and correct. <br /> Signature of Applicant: ✓1�,� Date: / �� .S �' `�� <br />