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CITY OF ORONO APPLICATION FOR PLUMBING PERMIT <br /> Box 66 (1335 So Brown Rd) r <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 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 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: —7&'_Resi'dential Commercial <br /> OWNER'S NAME: cZ/yi Phone No. : <br /> Mailing Address: City: pyA_7n <br /> CONTRACTOR'S NAME: A - Bus. No. : ?^ <br /> Mailing Address: City: Zip: - b <br /> Master Plumber's S ate Itidense City Cert. No. : <br /> PLUMBING FIXTURE SCHEDULE <br /> (Show number of fixtures of each type on each floor) <br /> FIXTURE TYPE BSMT IST FLOOR 2ND FLOOR OTHER FIXTURE TYPE BSMT IST FLOOR 2ND FLOOR OTHER <br /> -------------- ---------4-.... ---.r............. ................... ......... ................ <br /> WaterCloset <br /> ---- ---_---- --- f --- ----- SewerEjector <br /> -- --'---- ------- ---- <br /> Lavatory Laundry Tray <br /> ------------- ---- - //------------- ---------------------------- ---------------- <br /> Bathtub------ ----- ------- ---f --- ------ Washer------- ---- --------- --------- ----- <br /> Shower Water Heater <br /> Kitchen Sink Water Softner <br /> Disposal Wet Bar <br /> Dishwasher Sump Pump <br /> Sillcocks Misc. (List) <br /> ---------------------- <br /> Floor Drains <br /> 1. 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 /> LA 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: 4�?t7_4c.�'c' Date: 3� ' <br />