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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 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 /> B. All work must be inspected before it is covered. Call 473-7357. <br /> 24 hour notice required. <br /> JOB SITE ADDRESS: <br /> Occupancy Type: Residential Commercial <br /> OWNER'S NAME: , r, g,\� r 1� Phone No. : -173-9koS,3 <br /> Mailing Address: l City: <br /> CONTRACTOR'S NAME: K. Njcz1� ..t\ F�a.i�� Bus. No. : tl �� <br /> Mailing Address: c; _ e_z.,�k . <br /> .. ,�- City: Iri.;,6�?? Zip: <br /> Master Plumber's State License No. : Cl�,`I C,� r,-) 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 /> ------------- ---- -----1----- ---T----- ------ - <br /> Water Closet <br /> —�— 1- ' Sewer Ejector <br /> --------- ---'11 ---- ----- - <br /> Lavatory / Laundry Tray <br /> Bathtub ------ Washer <br /> ------------- -----�------- --�---- ------------- ---- -------- --------- ----- <br /> Shower- ' ------ Water Heater <br /> ------ -----�-- ----- ---—---- ----------- ---- ---•--------------------- <br /> Kitchen Sink Water Softner <br /> --------------+----- --•----- ----------------- ------------------- ---—-------------------- <br /> Disposal <br /> ---- ------ ------------- - <br /> Disposal I- ------ Wet Bar <br /> Dishwasher--- ---- ------ ------- Sump Pump------------------ -------------------------- <br /> Dishwasher <br /> --- --------- ----- <br /> ------------- ----- -- — -- ------- ------ ----------- -- ------ -------- ---- <br /> SillcocksMisc. (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• ' <br />