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�� CITY OF ORONO APPLICATION FOR PLDMBING PERIKIT <br /> Box 66 (1335 So Brown Rd) <br /> Crystal Bay, MN 55323 =�7�o� <br /> ********************************a�********************�* �*********� **** <br /> General Instrnctions ,' u O�' i <br /> 1. You may apply for plumbing permits by mail or in person at t ��dces. '� <br /> 2. Mailed in applications are subject to the postage and han� ng 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 yon 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. `I �C�t�� <br /> 6. When any new construction or remodeling is involned, a separa��5uild�ng permit muat <br /> be obtained. <br /> 7. Al1 work muat be done in accordance with State Code requirements. <br /> 8. All work must be inspected before it is covered. Call 473-7357. <br /> 24 hour notice reqaired. <br /> *************************************************************************** <br /> JOB SITS ADDRESS: � � �`-�CL�+v� � c�C/r9r* �� l�-�? <br /> Occupancy Type: v Residential Commercial <br /> OWNER'S NAM$: ��p+,� J� Phone No. : <br /> Mailing Address: City: <br /> CONTRACTOR'S NAI�: �r �'�-'1n`�t�r.���n 't��ti ('�i�q..Gr�t�.Bus. No. : �/or�'�3�_S,� <br /> Mailing Address: lQ �'l P :� �, R,�e �� City: �,��,�«[�J Zip�;a;�y�,�3 <br /> Master Plumber's State License No. : � Z�y City Cert. No. : <br /> ***************************************** * ******************************* <br /> PLIIMBING FIXTDRE SCHEDOL$ <br /> (Show number of fixtures of each type on each floor) <br /> FIXTURE TYPE BSMT 1ST FLOOR 2ND FI,OOR OTHER FIXTURE TYPE BSMT 1ST FLOOR 2ND FLOOR OTHER <br /> ������������= � �������= ���T����� ���� ������������� ���� ��������� ��������� ����� <br /> Water Closet � a Sewer Ejector <br /> ____________ I=� ___�__ ____,____ ______ _____________ ____ ___._____ _________ _____ <br /> Lavatory , I..I � � -____ Laundry Tray - <br /> ------------ -L ------- --------- - ----------- ---- ---•�---- --------- ----- <br /> Bathtub � --- ------ Washer <br /> ------------- -C-- ------- -- ------------- ---- ---�----- --------- ----- <br /> Shower �j I __ �___ ______ water Heater i <br /> ------------ -`- --•----- ------------ ---- --•----- --------- ----- <br /> Ritchen Sink ' I Water Softner <br /> -------------l-�-- ------ -------- ------ ------------- ---- ---�----- --------- ----- <br /> Disposal � Wet Bar f <br /> -------------1---- -.---- ----- ------ ----------- ---- ---.--- --�------ ----- <br /> Dishwasher I � S�p p�p <br /> ------------ ----- ---�--- -------- ----- ------------- ---- ------- ---------- ----- <br /> Sillcocks � Misc. (List) <br /> Floor Drains <br /> ___����__��__ � ��_ ���r_�� �� �_� �����_ ��_�����___ __� ��� �_� ���������� ��_�� <br /> *#**�Irtk*�k*********tk****�k�k*****�k**tF*�k**ir******�k**tk************tk�t�F*****ak***�t#* <br /> 1. Fiztnre Fee The minimum permit fee is $30.00 $ <br /> Compute number of fixtures r-� x $8/fixture <br /> x $S/fixture reset <br /> 2. State Snrcharqe $ .50 <br /> 3. Postage � Handling (Only mail-in applications) $ 1.50 <br /> 4. TOTAL PffitMIT FSE (add lines 1-3 above) $ �h "� � � <br /> ******************************************************* ******************* <br /> The undersigned hereby applies to the City of Orono for issuance of a Plumbing Permit, <br /> agrees 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 corr <br /> Signature of Applicant: Date: <br />