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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 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 /> 8. All work must be inspected before it is covered. Call 473-7357. <br /> 24 hour notice required. <br /> *************************************************************************** <br /> JOB SITE ADDRESS: / g 0/ / 1 7- -7.79- /Y) 1 0 <br /> Occupancy Type: 1,---Residential Commercial <br /> �-�^ <br /> OWNER'S NAME: V 0n') C'S' P/ JOU NT Phone No. : <br /> Mailing Address: I 7 0 I 1_iiS T :•, -i? y 7 b City: LONG t . -,<.L.-• . --.3--.3-6-6 <br /> CONTRACTOR'S NAME: F19-62 L- 4✓ /0_61 i"" ""..1- -S' 0 A/f Bus. No. : <br /> Mailing Address: S'-a 0 a41/d)hu9,l. City: Lb 4/ C i/3 k4,- Zip:2-,;m/ <br /> Master Plumber's State License No. : ?/ 73 /11 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 I ; 1 Laundry Tray 1 <br /> I <br /> Bathtub , j / Washer <br /> Shower t 4 / Water Heater ' <br /> - '-- l <br /> Kitchen Sink f j Water Softner <br /> -- <br /> Disposal I — — Wet Bar -- <br /> 1 L <br /> Dishwasher 1 j - Sump Pump <br /> Sillcocks Misc. (List) <br /> Floor Drains <br /> i -I <br /> *************************************************************************** <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 /> *************************************************************************** <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: -----/ ?-"C:1/ <br />