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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 ha ,ees-afiownelow. <br /> Permit cards will be sent by return mail the same day the ap catioff&is receiveld. <br /> 3. Permits are not valid until you receive a permit card. JI <br /> 4. Work must not begin unless the permit card is available on t ` b s te. <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 requiremenUA R 2 3 1992 <br /> 8. All work must be inspected before it is covered. Call 473-7357. <br /> 24 hour notice required. <br /> *************************************************************************** <br /> JOB SITE ADDRESS: 505 Orchard P f2, P?d <br /> Occupancy Type: V Residential Commercial <br /> OWNER'S NAME: Qgjtr) kekis h Phone No. : 1--(p - ao0S- <br /> Mailing Address: 5 Orchard PI Pd City: —157pq Lp .o_, <br /> CONTRACTOR'S NAME: Nt3a.l Bus. No. : q 33- -1a.60 <br /> Mailing Address: (003) Ce' '"""ut City: r4 <br /> fl a Zip: <3q <br /> Master Plumber's State Licens No. : a City Cert. No. : <br /> *************************************************************************** <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 /> a T .. <br /> Water Closet Sewer Ejector <br /> Lavatory Laundry Tray <br /> Bathtub Washer <br /> Shower Water Heater <br /> Kitchen Sink + Water Softner I <br /> Disposal I `--` ---- Wet Bar —_ <br /> Dishwasher Sump Pump <br /> Sillcocks Misc. (List) <br /> Floor Drains <br /> *************************************************************************** <br /> 1. Fixture Fee The minimum permit fee is $30.00 $ 30 , 617 <br /> Compute number of fixtures x $5/fixture <br /> x $3/fixture reset <br /> 2. State Surcharge $ .50 <br /> NA <br /> 3. Postage & Handling (Only mail-in applications) $ 1.50 <br /> 4. TOTAL PERMIT FEE (add lines 1-3 above) $ 3 a`Q <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: 3'-17-2 <br /> CULL .AN WATER CONDITJONING <br />