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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 /> r, <br /> General InstructionsIj� <br /> 1. You may apply for plumbing permits by mail or in person at the City offices J <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 /> ail �y <br /> 6. When any new construction or remodeling is involved, a separate IJLii-ld g�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 /> *************************************************************************** <br /> JOB SITE ADDRESS: 147(p) (-J s( &d n[, ) k'4 <br /> Occupancy Type: ? Residential Commercial <br /> OWNER'S NAME: Pe.-i-e( (6Or-4-)c Phone No. : 474- '43�c <br /> Mailing Address: 4-7(00 u) branr to (2d City: Y11&ure./ <br /> CONTRACTOR'S NAME: Cakl�✓� Bus. No. : -13 �7a--C11) <br /> Mailing Address: Li)p30 CLULLAcirLin IOU.( City: r 1c&_- Zip: <br /> Master Plumber's State License Nb. : 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 /> Water Closet [- Sewer Ejector <br /> Lavatory Laundry Tray <br /> Bathtub Washer <br /> Shower Water Heater <br /> Kitchen Sink 1 - ----- Water Softner <br /> Disposal I `--- ------ Wet Bar ( -- <br /> Dishwasher 1 Sump Pump <br /> Siilcocks 1 ----- IMisc. (List) 1 ---_ I <br /> Floor Drains I1 1 - <br /> *************************************************************************** -- <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) $ 21.50 3 <br /> 4. TOTAL PERMIT FEE (add lines 1-3 above) $ � UP <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 /> 7-7— 2- <br />