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CITY OF ORONO APPLICATION FOR PLUMBING Plqu'1T <br /> Box 66 (1335 So Brown Rd) <br /> Crystal Bay, MN 55323 <br /> ********************************************* ****************t•********** <br /> General Instructions <br /> 1. You may apply for plumbing permits by mail or in parson at the City offices. <br /> 2. Mailed in applications are subject to the post tge and handling f eis s s received. <br /> below. <br /> Permit cards will be sent by return mail the same day the app <br /> 3. Permits are not valid until you receive a permit ard. <br /> 4. Work must not begin unless the permit card is ava' lable on the job site. <br /> 5. Plumbing permits may be issued to licensed contra!tors only. <br /> 6. When any new construction or remodeling is involy*ed, a separate building permit most <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: / ) p <br /> Occupancy Type: <br /> Residential Commercial <br /> OWNER'S NAME: 0-0/.7.4-c-IC ,12/Z� PU/Y� �PhoneCNoy: Q�� U/V U Lone LfK <br /> o. : <br /> Mailing Address: / O / L,/ /? M <br /> /�/ ,O/� ,4,��l/Y Bus. No. : <br /> CONTRACTOR'S NAME: G :-/9--,<_(- <br /> Mailing Address: A--2,0 ed2/ 7)-7 Lt city: No. : <br /> Zip: <br /> Master Plumber' s State License No. : <br /> 3 17JM C City Cert. No. : <br /> PLUMBING FIXTURE SCHEDULE <br /> (Show number of fixtures of each type on emch floor) <br /> FIXTURE TYPE BSMT 1ST FLOOR 2ND FLOOR OTHER FIXTURE TYPE 'BSMT 1ST FLOOR 2ND FLOOR OTHER <br /> Tv. <br /> Water Closet Sewer Ejector <br /> Lavatory / Laundry Tray <br /> ---- --` <br /> Bathtub / Washer _ �•- <br /> Shower Water Heater _ _ <br /> Kitchen Sink j ---- - — Water Softner <br /> / Wet Bar (. <br /> 1 <br /> Disposal I <br /> _�___.__.,_ <br /> I / --- --- Sump Pump <br /> Dishwasher _ --- - <br /> Sillcocks / Misc. (List) --_- <br /> Floor Drains I / _ <br /> *************************************************************a************* <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 /> $ ..50 <br /> 2. State Surcharge <br /> 3. Postage & Handling (Only mail-in applications) $ <br /> 1.50 <br /> 4. TOTAL PERMIT FEE (add lines 1-3 above) $ <br /> ***************************************************************1*********** <br /> The undersigned hereby applies to the City of Orono for issuance of a Pluitbing Permit, <br /> .ty and the <br /> agrees to do all work in to oftMinnesota,rict dordinancesance with the <br /> and certifies thatal lstatements4.made on this <br /> regulations of the Sta <br /> application are complete, true and orr-' <br /> Signature of Applicant- V. <br /> Aili� Date: <br /> I. <br />