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CITY OF ORONO APPLICATION FOR PLO '� T <br /> Box 66 (1335 So Brown Rd) @ O <br /> Crystal Bay, MN 55323 L5 <br /> General Instructions <br /> 1 1. You may apply for plumbing permits by mail or in person at the City ce"s`.� 3 <br /> 2. Mailed in applications are subject to the postage and handling s shown below., <br /> Permit cards will be sent by return mail the same day the applicat on is re <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 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 /> JOB SITE ADDRESS: _ 1t 7 1 9, — Sh o r-e <br /> Occupancy Type: L.-- Residential Commercial <br /> OWNER'S NAME: G%_0e,r1 r`' " Phone No. : Ll -]a - ��9 9 <br /> Mailing Address: L{1q�- 1(1 �re City: 7E5roe%o <br /> CONTRACTOR'S NAME: Bus. No. <br /> Mailing Address: \; \ - ,r1 City: _`bLe" r,.Q <br /> Master Plumber's State License No. : City Cert. No. : <br /> PLUMBING FIXTURE SCHEDULE <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 Laundry Tray <br /> ------------ -------------------------------- --------------------------------------- <br /> Lavatory Washer <br /> ----------- ------ ----- --------------- ------------------------------ <br /> Bathtub <br /> ------ ----- -------- <br /> Bathtub Water Heater <br /> ----------- ----- ---------------------------------------- ------------------------------ <br /> Shower <br /> ----------- <br /> ------- ----- ------ <br /> Shower ---- ---- Water Softner <br /> -------------------- <br /> L-------------------------- <br /> Kitchen <br /> --- ----- ------ <br /> Kitchen Sink Misc. (list) <br /> ----------- ---- ------ ----- --- <br /> Disposal <br /> ------ ----- --- <br /> ----------- ---- <br /> Dishwasher <br /> ----------- ---- ------ ----- - <br /> Wet Bar <br /> ---- ------ ----- --------- -------- ---- -------------- -------- ----- <br /> Silicocks <br /> ----------- ---- ------ ----- <br /> Floor Drains <br /> -------------------- --------- ------------------------------------------ <br /> Sump Pump <br /> Sewer Ejector <br /> 1. Fixture Fee The minimum permit fee is $30.00 $ CAD <br /> Compute number of fixtures x $4/fixture <br /> 2. State Surcharge $ .50 <br /> 3. Postage i Handling (Only mail-in applications) $ 1.50 <br /> 4. TOTAL PERMIT FEE (add lines 1-3 above) <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 cer ifies that all statements made on this <br /> application are complete, true an or ct. <br /> Ginnature of Anolicant: Date. <br />