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CITY OF ORONO APPLICATION FOR PLUMBING PERMIT <br /> Box 66 (1335 So Brown Rd) <br /> Crystal Bay, MN 55323 <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 /> S. All work must be inspected before it is covered. Call 473-7357. <br /> 24 hour notice required. <br /> JOB SITE ADDRESS: 2-`70-1 WAKEFIELD k o a c( <br /> Occupancy Type: _Residential Commercial <br /> OWNER'S NAME: PLFI4k6HPO L- CONST` Phone No. : 93 ate 1- <br /> Mailing Address: 8609 HAWrE 411C So City: <br /> CONTRACTOR'S NAME: VITLTEW f l3LA yGOG4 I NC Bus. No. : �'8 - 3 1-7 1 <br /> Mailing Address: f IIf !p(v ST City: 4vo,%470 Ft Zip: SS .20 <br /> Master Plumber's State License No. : /y5-tl -M City Cert. Nd. : <br /> *************************************************************************** <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 /> ----- ------ ---- ----+----- ---t----- ------ ----- ------- <br /> -4 ---- ----�---- --------- ----- <br /> Water Closet Sewer Ejector <br /> -------------- -------- <br /> Lavatory Laundry Tray <br /> ------------- ---- ------- --- ------------ ---------------------------- --------- ----- <br /> Bathtub i Washer <br /> --------------------------- ------- ------ ------------- ---- --- ------ ----- <br /> Shower Water Heater <br /> Kitchen Sink Water Softner <br /> ------------- ----- -------- -------- ------ ------------- ---- ------------------------ <br /> Disposal <br /> --- --------- ----- <br /> Disposal Wet Bar <br /> ------------- -------- ------- ------ ------------------ ---•-------------------- <br /> Dishwasher <br /> --- --------- ----- <br /> Dishwasher Sump Pump <br /> Sillcocks Misc. (List) <br /> Floor Drains <br /> ------------- ----- ---�=--- -- ---- ------ ------------- ---- <br /> 1. Fixture Fee The minimum permit fee is $30.00 $ Z) <br /> Compute number of fixtures �2_ 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) $ 30 . Sc> <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: �r� <br />