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CITY OF ORONO APPLICATION FOR PLUMBING PERMIT <br /> •, Box 66 (]_335 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 /> 8. 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: W,/ 10/(f_ Phone No. : <br /> Mailing Address: City: <br /> CONTRACTOR'S NAME: /Ale- <L. Bus. No. : <br /> Mailing Address: , ,.�, zs�C,/ // City: Zip:, <br /> Master Plumber's State License No. : /)1 /U%Z City C rt. 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 IST FLOOR 2ND FLOOR OTHER <br /> ------------ -+----- ---T----- ------ ------------- ----- --------- -------- <br /> Water Closet- ( Sewer Ejector <br /> ----------- ----�---—---- ------------------ ---------------------------- ---------- ----- <br /> Lavatory Laundry Tray <br /> -------------- ---- -`J-t l ------ ------ ---------------------------- ---- <br /> Bathtub <br /> ----------- -- ---'--- ------- ---- <br /> Bathtub / Washer <br /> ----�-I U rYY�- - K' �__ <br /> ------------- - --------------- --------------- <br /> Shower �- ��TG`( ------ Water Heater - - - <br /> ------------ --- -_�- ------- ---------- --•--------------------- <br /> ZI <br /> Kitchen SinkI�JT Water Softner e <br /> -------------�---- - -- --------------- ------------------ ----------------------- <br /> DisposalI- 2_ Wet Bar <br /> ------------ 1 --- --- -------------- ------------------ --------- -------- ---- <br /> Dishwasher ------ Sump Pump <br /> -------------1---- � --_--- ------------ -- ----------------------- <br /> sSillcocki�t�r� 3 Misc. (List) �7, / !/? 1� <br /> %`i <br /> Floor Drains f�fel 3 <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 /> 3. Postage & Handling (Only mail-in applications) $ ,( 1.50 <br /> 4. TOTAL PERMIT FEE (add lines 1-3 above) $ __/��, -5C' <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: a�- zi - �Y� i�� Date: 3�j Z <br />