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' ---- , 4 <br /> CITY OF ORONO APPLICATIOH FOR PLOI�ING PffitMIT ; . <br /> B�x 66 (1335 So Brown Rd) { ' - <br /> �� Crystal Bay, MN 55323 I `��;� 7 <br /> *******************************************�*******�***** �**************J <br /> General Instrnctions . � <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 postaqe and handling fees ahown below. <br /> Permit carda 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. �,�91 <br /> 4. Work must not beqin unleas the permit card ie available on the job s��.B 2 � <br /> 5. Plumbing permits may be issued to licensed contractors only. <br /> 6. When any new construction or remodelinq is involved, a separate bui'Iding 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. 24 hour notice <br /> required. <br /> *********��**************************************************************** ' <br /> JOB SIT$ ADDRESS: ��(),� �,I.�re/�/t�rJ�� . <br /> Occupancy Type: x Resident al Commercial <br /> OWNffit'S NAI�: Phone No. : <br /> Mailing Address: City: <br /> CONTRACTOR'S NAN�: i r� I �' � r- Bus. No. : l�J" rI � `. <br /> Mailing address: ��'rni 1u-1-IL, `�,K-Iv���c-;2J� �i City: M-H�C'A` Mr.� �5� S t�'"-' ; <br /> Master Plumber's State License No. : i� � ''�7(0 3 City Cert. No. : <br /> ***********************************************************************�*** <br /> PLOl�ING FIXT[JRB SCH$DOL$ <br /> (Show number of fixtures of each type on each floor) <br /> FIXTIIRS TYPE BSMT 1ST FLOOR 2ND FLOOR OTHER FIXTURE TYPS BSMT 1ST FLOOR 2ND FLOOR OTHER <br /> ------------- ---- --------- --------- ------ ------------- ----- -------- --------- ----- <br /> Water Closet t Sewer Ejector • <br /> ------------- ---- --------- --------- ------ ------------- ----- -------- --------- ----- <br /> Lavatory ' Laundry Trsy <br /> ------------- ---- --------- --------- ------ ------------- ----- -------- --------- ----- <br /> Bathtub Washer <br /> ------------- ---- --------- --------- ------ ------------- ----- -------- --------- ----- <br /> Shower � Water Heater ' <br /> ------------- ---- --------- --------- ------ ------------- ---- -------- --------- ----- <br /> Ritchen Sink Water Softner <br /> ------------- ---- --------- --------- ------ ------------- ----- -------- --------- ----- <br /> Disposal wet Bar <br /> ------------- ---- --------- --------- ------ ------------- ---- -------- --------- ----- <br /> Dishwasher Sump Pump <br /> ------------- ---- --------- --------- ------ ------------- ---- -------- --------- ----- <br /> Sillcocks Misc. (List) ' � � o <br /> Floor Drains <br /> ***************************************�*********************************** <br /> 1. Fixture Fee The minimum permit fee is $30.00 $ �O� O C� <br /> Compute number of fixtures x $4/fixture <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) $ �c�, d Q <br /> *************************************************************************** <br /> The undersigned hereby applies to the City of Orono for issuance of a Plumbing Permit, <br /> aqrees 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. ,j <br /> Signature of Applicant:�/ u,C'�'7�z ��/1�-�,�6'0� Date: o�-p7lJ - 9/ <br />