Laserfiche WebLink
� , CITY OF ORONO APPLICATION FOR PLDMBING PERMIT <br /> Box 66 (1335 So Brown Rd) <br /> Crystal Bay, MN 55323 <br /> *************************************************************************** <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 postage and handling fees shown 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 permit card. <br /> 4. Work must not begin unless the permit card is anailable on the job site. <br /> 5. Plumbing permits may be issued to licensed contractors only. <br /> 6. When any new construction or remodeling is involved, a separate building permit must <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 honr notice reqaired. <br /> ******************************************** ****************************** <br /> JOB SITB ADDRESS: lO(� �JC.I �L�V <br /> � Occupancy Type: 'X Residen al Commercial <br /> . OWNER'S NAME: _��;;r,�,,_-�n,c��m�i� Phone No. : <br /> Mailing Address: City: <br /> � CONTRACTOR'S NAN�: Bu s. No. : Q���I�\1 <br /> � Mailing Address: 1_ 1 Ita� City: (v��-1�.�, Zip:S�3�\'� <br /> � Master Plumber's State License No. : M-�'1�,3 City Cert. No. : <br /> - *************************************************************************** <br /> PLIIMBING FIXTIIRE 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 OTHER <br /> � ------------- ---- ---�----- ----r----- ----- ------------- ---- ----�---- --------- ---- <br /> Water_Closet_�_�.!�---�-- --�---- ------ Sewer_Ejector ---- ---•----- ---------I----- <br /> . LavatorY-----�-� ' -- --�---- ------ Laundry-TraY- ---- ---�I---- -------- ' ---- <br /> -7--�- -L- <br /> _ Bathtub-------�----I ------- - -- ------ Washer------- ---- --- - -------- I ---- <br /> L -�- ^-- -� -L- <br /> ` _ Shower-------�-� � -•----- -�--- ------ Water_Heater- --1- --�----- -------- � ---- <br /> �r� �i� <br /> - Ritchen_Sink � -_- + - � _-_ ___--___ ______ Water_Softner -+ _ �-i�� O�t__ __I __-__ <br /> 1 ' <br /> -�- -� - - Wet Bar � i <br /> Disposal � <br /> -------------1-----' ----- ------- ------ ------------- ---- ---.---- ---------�----- <br /> . Dishwasher---1---- � - � •-- -------- ------ S�P-P�p---- - 1 . c! - ---- - - ----- <br /> . � Sillcocks--- -�- --•--- --------- ------ Misc�_(List)_ _ � ,� ��C " __ �__�sj�_ � -- <br /> - - �`� � 'F <br /> � Floor Drains _�_ � `� �1 �y� - ----- <br /> 0. <br /> . _���_������__ -_ _���=��_ �__�����_ _�_��_ ��_�_�_��_��� ____ ��_..� � <br /> - . . �k*�k*******�Ir�r*ik**#�Ir�F�k****�t*tk*****�k****�k*****�F�it**********�F*�k�Y*�lt**�r**�k****�Ir*** <br /> 1. Fixture Fee The minimum permit fee is $30.00 $ � ��.� <br /> Compute number of fixtures � x $5/fixture <br /> � � x $3/fixture reset <br /> . <br /> - . 2. State Surcharge $ .50 <br /> _ � � <br /> -; � 3. Postaqe � Handlinq (Only mail-in applications) $ --�:-5-9- <br /> � 4. TOTAL PERMIT FE$ (add lines 1-3 above) $ � ��. � . <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 correct. <br /> ' Signature of Applicant�%1l�-� _ �p(�ij„�� Date: �� ~�I�-`�/ <br />