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CITY OF ORONO APPLICATION FOR PLUMBING PERMIT <br /> Box 66 (1335 So Brown Rd) <br /> Crystal Bay, MN 55323 <br /> *************************************************************************** <br /> General Instructions <br /> 1. You may apply for plumbing permits by mail or in person at the City offic3s. <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 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. <br /> 24 hour notice required. <br /> JOB SITE ADDRESS: i <br /> Occupancy Type: Residential Commercial <br /> OWNER'S NAME: Phone No. : S to, <br /> Mailing Address: i City: <br /> CONTRACTOR'S NAME*tate <br /> n Bus. No. : V "�'7 // <br /> Mailing Address: • City: - Zip.. _S D <br /> Master Plumber's L ense No. : // City Cer 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 /> -z----- ---- ---- ---- ----- - <br /> Water Closet ' � / ----- Sewer Ejector <br /> -------------1---- -------- - -.--- ---------- ---- -------- ------- ----- <br /> --r - <br /> Lavatory ! �- Laundry Tray <br /> ------------- I-1 --------}-------- ------ ----------------- --i---- --------i----- <br /> - - - - <br /> Bathtub / i ------ Washer <br /> -------------1- -- --------i------- ----------- ---- ---^---- --------------- <br /> Showerj ! I /' Water Heater <br /> ------ ---- - .--j------------- ------------------- --------- ---------I----- <br /> Kitchen Sink Water Softner <br /> Disposal / ----- Wet Bar j <br /> -------------�---- ---- ------ ---------------------------- <br /> Dishwasher ------ Sump Pump <br /> -------------1---- = - -- --- -- --------- -- ------ -------- ---- <br /> Sillcocks Misc. (List) <br /> Floor Drains <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 /> 2. State Surcharge $ .50 <br /> 3. Postage & Handling (Only mail-in applications) $ 1.50 <br /> 4. TOTAL PERMIT 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: o� <br />