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� <br /> � CITY OF ORONO APPLICATION FOR PLUMBING PERMIT <br /> � Box 66 (1335 So Brown Rd) � ��3 <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 constructior. 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 honr notice required. <br /> rt*****,t****************************** *************,t******,t**************** <br /> JOB SITE ADDRESS: �l�(05'- `�ry�.ea7 �: ��L. <br /> Occupancy Type: x Residential Commercial <br /> OWNER'S N11ME: (y, !(f, pj'�G�� Phone No. : ��� ` oy,._3� <br /> Mailing Address: ��,,,,,� City: <br /> CONTRACTOR'S NAME: y Bu s. No. : �S ��'"0�`3 <br /> Mailing Address: �,u� City: � � � Zip:.�� <br /> Master Plumber' s State License . . /�ij /(�/� City Cert. No. : <br /> *************************************************************************** <br /> PLUMBING FIXTURE SCHEDULE <br /> (Show number of fixtures of each ty�e on each floor) <br /> FIXTURE TYPE BSMT 1ST FLOOR 2ND FLOOR OTHER FIXTURE TYPE BSMT 1ST FLOOR 2ND FLOOR OTfiER <br /> ------------ -a----- ---T----- ------ ------------- ---- --------- --------- ----- <br /> Water Closet Sewer F ector <br /> -------------�---- ---—---- ---- ---- ------ -------]----- ---- ---•----- --------- ----- <br /> Lavatory Laundry Tray � <br /> Bathtub Washer <br /> ------------ ----�------- ----- ------ ------------ --- -------- --------- ----- <br /> - - , - - - - �- - <br /> Shower -----_ Water Heater <br /> Ritchen Sink ' ----__ Water Softner <br /> -------------�---- -•---- ------ ---------- -- --•---- -------- ---- _ <br /> Disposal I_ Wet Bar <br /> -------------1 --- ---- ----- ---- ----------- -- --�---- -------- ---- <br /> Dishwasher__- I_ Sum Pum <br /> --------- 1 --- --- -- ------ ----- ---p----P---- -- ------- ---------- ----- <br /> Sillcocks ---_-- Misc. (List) � <br /> Floor Drains <br /> *************************************************************************** <br /> 1. Fixture Fee The minimum �ermit 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 b 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 Dtinnesota, and certi.fies that all statements made on this <br /> application are complete, true and correct. <br /> . <br /> I <br /> Signature of A�;pl�cant: .� 2� Dat:e: ��-v?�-y� <br />