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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 0,) <br /> Occupancy Type: X Residential Commercial ; <br /> OWNER'S NAME: ��l^c C -� __ Phone No. : <br /> Mailing address: fS� („-.Jer City: <br /> CONTRACTOR'S NAME: Bus. No. : <br /> Mailing Address: City: Zip: <br /> Master Plumber's State License No. : City Cert. 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 /> Water-Closet-I--- I -- ----Closet --- <br /> ---- ----- Sewer-Ejector ---- --_----- ---------r----- <br /> Lavatory J Laundry Tray <br /> - I ----- -------- ------------- ------- - <br /> BathtubWasher <br /> -- --- ------ --- --- ----------rLI - <br /> ---- <br /> ------------- - <br /> Shower 7 Water Heater <br /> --- -- ----- - <br /> ---- -------- --------- ----- <br /> Kitchen Sink i I Water Softner <br /> ------------------ --- ---- ------ ---------—---- --------- ----- <br /> Disposal I I Wet Bar <br /> 1-----I------ ------------------------------------------- ---------Sum ----- <br /> Dishwasher ------ P Pum P <br /> Sillcocks Misc. (List) <br /> Floor Drains <br /> ------ ----- --- ------ ------------- ---- -------- ---------------- <br /> 1. <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 /> 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 j <br /> regulations of the State of Minnesota, and certifies that all statements made on tis <br /> h <br /> application are complete, true and correct. <br /> Signature of Applicant: txf., Date: �U3/�� <br />