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�ITY OF ORONO � , APPL'ICATION FOR PLUMBING PERMIT � <br /> ox 66 (1335 So Brown Rd) � �J <br /> rystal Bay, MN 55323 ��70 <br /> ******************************************************** **************** <br /> neral instrnctior�s <br /> 1 You may apply for plumbing permits by mail or in person at the City offices. <br /> 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 /> Permits are not valid until you receive a permit card. <br /> Work must not begin unless the permit card is available on the job site. <br /> Plumbing permits may be issued to licensed contractors only. <br /> When any new construction or remodeling is involved, a separate building permit must <br /> be obtained. <br /> All work must be done in accordance with State Code requirements. <br /> All work must be inspected before it is covered. Call 473-7357. <br /> 24 honr notice required. <br /> **************************************,t*********************************** <br /> OB SITE ADDRESS: ��/ I S Sti.55�� ���� <br /> ccupancy Type: ,X Residential Commercial <br /> WNER'S NAME: �o t� ie rc� Phone No. : �7(o � �/ ��/ <br /> ailing Address: � r,�� �, ;,,Q City: 4Nq L..Q e h--s3s6 <br /> ONTRACTOR'S NAME: _�T�c v� �t yt p��we �if�C_ Bu S. N . �Z� - Z 3 L I <br /> ailing Address: z�Z� - 2�� �¢vE- City: �� Zip: 53��03 <br /> aster Plumber's State License No. : 31,y 2 pNl City Cert. No. : <br /> ************************************************************************** <br /> PLUMBING FIXTURE SCHEDULE <br /> � (Show number of fixtures of each type on each floor) <br /> XTURE TYPE BSMT 1ST FLOOR 2ND FLOOR OTHER FIXTURE TYPE BSMT 1ST FLOOR 2ND FLOOR OTHER <br /> - ----------- ---- ----+----- --T---- ------ ------------ --- ----�--- ------- ---- <br /> ter Closet 1 Z � Sewer Ejector <br /> — --------- ----- <br /> vatory I � � Laundry Tray � <br /> ------- ---- ---�----- --------- ----- <br /> thtub Z Washer / <br /> ----------- -----�------- ------- ------ ------------- ---- -------- --------- ----- <br /> ower r Z Water FIeater r <br /> , <br /> --• ---- --------- ----- <br /> itchen Sink 'I � Water Softner <br /> -----------+----- --�---- -------- ------ ------------ ---- ---�---- ------- ---- <br /> isposal I_ � Wet Bar � � <br /> ------------1 ---- ------ ------- ------ ------------- ---- ---•---- -------- ---- <br /> ishwasher � Sump Pump <br /> — -- ---------- ----- <br /> illcocks '� Misc. (List) <br /> ------------ ----- ---•--- --------- ------ ----�G�----- ---- ---- --- ---------- ----- <br /> loor Drains '�,� q2-� � / <br /> ------------ ----- ---�---- --------- ------ ---�J-------- ---- -------- ---------- ----- <br /> ************************************************************************** <br /> . Fixture Fee The minimum permit fee is $30.00 $ <br /> Compute number of fixtures x $8/fixture <br /> x $5/fixture reset <br /> . State Surcharge $ .50 <br /> . Postage � Handling (Only mail-in applications) $ 1.50 <br /> . TOTAL PERMIT FEE (add lines 1-3 above) $ <br /> ************************************************************************** <br /> he undersigned hereby applies to the City of Orono for issuance of a Plumbing Permit, <br /> grees to do all work in strict accordance with the ordinances of the City and the <br /> egulations of the State of Minnesota, and certifies that all statements made on this <br /> pplication are complete, true and correct. <br /> � <br /> ignature of Applicant: �' - �i��^� Date: 7 — � ���- <br />� I� <br />