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_ .. ._- -- ---. - - ._ .._ _.._______._ .. .___..__ <br /> Box 66 (1335 Brown Road South) �� �/ <br /> Crystal Bay, MN 55323 <br /> *****************************,�******************************************** <br /> General Information <br /> 1. You may apply for plumbinq permits by mail or in person at the City offices. <br /> 2. Mailed in application are sub ject to the postage and handling fees shown below. Permit Cards will <br /> 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 /> q, Work mu�t not beqin until the permit card is posted on the job site. <br /> 5. Plumbing pesmits may be iseued to atate-licensed plumbezs or to homeowner/occupante who intend to � <br /> actually pezform their own work in their home. <br /> 6. when any new construction or remodeling is involved, a separate buildinq permit must be obtained, i <br /> 7. All work must be done in accordance with the State Buildinq Code Requirements. <br /> 8. All work must be inspected before it is covered. Call for inspectione 24 houra in advance <br /> (473-7357I. <br /> Instructions. Complete all itema on this application. Compute the permit fee. Siqn an8 date the <br /> certification. Incomplete applications will not be processed. If you have.any questions, call <br /> 473-7357. <br /> WALK-IN PERMITS--Apply at Cfty Offices, 1335 Srown Road So. (County Rd 146? <br /> MAIL-IN PERMITS--Enclose Fee--Meil to: P.O. Box 66, Crystal Bay, F!N 55323 <br /> _ _ - --- <br /> *�k*�k*�ktktR*tktk*tk�k�r**tktktk**�r*tk*alr****�lr�lr**ir�r�k�r***tk�k�k*aF �k�k*�r*�k*�r*�Irtkak*�ktk�ktk****tktk*#t <br /> JOB SITS ADDRESS ZOO �� - <br /> Occupancy Type: Residerytial Commercial <br /> Work to be Performed by: f/ Licensed Contractor Owner/Occupant <br /> OWNER's NAM� Telephone No. -�f�,S� <br /> Mailing Address <br /> PLOMBER'S COMPANY NAME � S /GO�i Business No. �D <br /> Mailing Address . • <br /> Master Plumber' s State License No.���� City Cert. No. <br /> *************************************�************************************ <br /> PLOMBING FIXTITR$ SCH$DIILE <br /> (Show Number of Fixtures of Each Type on Each Floor) <br /> FIXTURE tYPE BSi�1T. lsG Floor 2nd Floor Other Floora FIXTUAE TYPE BS!!T. lst Floor 2nd Floor Other Floors <br /> water Closet � / !/ Laundr Tra � <br /> Lavatorv Washer <br /> eathtub ( � water iieater <br /> Shower _ Water Softner � <br /> Kitchen Sink Misc. Fixtures: <br /> Disposal (Lisc) <br /> Dis4was::er � <br /> WeC Bar <br /> Sillcocks Z <br /> Floor Drains � <br /> Sum Pum <br /> Sewer E ector M. OF F XTURES <br /> tkdttk*tk�k*1klktk**tklk�k�ktk*7ktk***�k�rir�k*tktkiF*�t�Ar�ktk*akdr�k***ik�r*�t�itttlk#�r*�4**drtk***tk�r*t4tk�k*dFtktk** <br /> � P8RIKIT FLE CALCIILATION <br /> 1. Fixture Fee. The minimum permit. fee is $25. 00. <br /> Compute number of fixtures �_ x $4/fixture $ � � � <br /> 2. State Surcharge $ .50 <br /> 3. Postage and Handling (Only for Mail-in applications) $ 1.50 <br /> 4. TOTAL Permit Fee (Add lines 1-3 above? $ �� �� <br /> **************�****************************************************�****** <br /> The undersigned hereby appliee to the City of Orono for issuance of a PLUMBING PERMIT, agreee to do all � <br /> work in strict eccordance with the ordinances oF the City nnd the requlations of the Minneaote State <br /> corrdi�g Co , and certifiee that a statements made on this application ere complete, true and � <br /> I <br /> � ��� � <br /> gna e of 1 Date � <br /> . � <br />