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CITY OF ORONO APPLICATION FOR PLUMBING PERMIT ,� <br /> Box 66 (1335 So Brown Rd) . � <br /> Crystal Bay, MN 55323 ��.; ,5 � �L� !�- <br /> ***************************************************************** ******** <br /> General Instructions <br /> 1. You may apply for plumbing permits by mail or in person at the City officea. <br /> 2. Mailed in applications are subject to the postage and handling 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 you 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. <br /> 6. When any new construction or remodeling is involved, a separate building permit must <br /> be obtained. <br /> 7. All work muet 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 /> ************************��*�***** **********rt** * ********************** <br /> JOB SITE ADDRESS: O <br /> Occupancy Type: Residential Comme cial <br /> OWNER'S NAME: � Phone No. : <br /> Mailing Address: r City: _n-y}�- <br /> CONTRACTOR'S NAME: '� J `� `� � Bu s. No. : � ��S i`"� <br /> Mailing Address: w r � City:� Zip: �s6 <br /> Master Plumber's State icense No. : � City t. 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 OTHER <br /> ------------- ---- ----+----- ---�----- ------ ------------- ---- ----�--- ------- ---- <br /> Water Closet �`�i . Sewer Ejector <br /> ------------- =L=- ---�--- ---�- -- ----- ------------- --- --•---- ------- ---- <br /> Lavatory P�(_ � � Laundr Tra <br /> ------------- ��'X ---—---- ---/--- ------ ------y----y- ---- ---•�---- --------- ----- <br /> Bathtub ----__ Washer <br /> ------------- ----- ------- ------- ------------ ---- --�-- ------- ---- <br /> Shower _____- Water Heater <br /> ------------- ��-- --•----- --�---- ------------- � ---•---- ------- ---- <br /> Ritchen Sink ' Water Softner <br /> ------------- ----- --�---- -------- ------ ------------- ---- ---�---- -------- ---- <br /> Disposal / Wet Bar �J <br /> ------------- ----- --1---- ------- ------ ------------- ---- '�•---- -------- ---- <br /> Dishwasher / Sump Pump <br /> ------------- ----- --/—•--- --------- ------ ------------- � ------ -------- ---- <br /> Sillcocks Misc. (List) <br /> ------------- ----- -p'�—•--- --------- ------ ------------- ---- ---�—--- --------- ---- <br /> - - <br /> Floor Drains f <br /> *****************#********************************************************* <br /> l. Fixture 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 PSRMIT FEE (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: Date: (� a � � <br /> �� <br />