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. . <br /> CITY OF ORONO APPI�ICATION FOR PLDI�IBING PERMIT <br /> ______ Box 66 (1335 So Brown Rd) /_Q�� <br /> Crystal Bay, MN 55323 « <br /> ��**�*�*****�*�t******��*�*�r****�r****��**********�r�t******�********�********* <br /> General Instrnctions <br /> 1. You may apply for plumbing permits by mail or in person at the City offices. <br /> 2. Mailed in applications are sub�ect to the poatage and handling fees ahown below. <br /> Permit cards will be sent by return mail the same day the applicatioa is received. <br /> 3. Permits are not valid aatil yon receive a permit card. <br /> 4. Work must not begin unless the permit card ie 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 pera►it must <br /> be obtained. <br /> 7. All work must be done in accordance with State Code requirementa. <br /> 8. A1 1 work must be inspected before it is covered. Call 473-7357. <br /> 24 honr notice reqnired. <br /> ***�*�r***�e**************�t**�c*****�****** *****�c****�********�*�e�**�t******** <br /> JOB SITE ADDRESS: //� L�� <br /> Occupancy Type: � Residential Commercial <br /> OWNER'S NAI�:: �2, � Phone No. : /i��� <br /> Mailing Address: �s City: �,��. <br /> CONTRACTOR'S NAN�:: Bu s. No. : �-��7 <br /> Mailing Address: City: ��.�., Zip:C,,� <br /> Master Plumber's State License No. : City Cert. No. : <br /> *******�r*****************************************************�************* <br /> PLDNIDING FIXTnRE SCHEDULE <br /> (Show number of fixtures of each type on each floor) <br /> FIXTURE TYPE BSMT 1ST FLOOR 2ND FLOOR OT�R FIXTURE TYPE BSMT 1ST FLOOR 2ND FLOOR OTHER <br /> ------------- ---- ----�---- ----r---- ------ ------------- ---- ----•---- --------- ----- <br /> Water-Closet -__ ---__- _�- _-_ -_-- Sewer Ejector -_ ___ -_-- -------- ----- <br /> Lavatory---- --- ------ / -- ---- Launc3ry Tray -- --•----- ------- ---- <br /> Bathtub----- --- -�--- � -- ----- Washer------- --- ---^---- -------- ----- <br /> Shower Water Heater <br /> Ritchen_Sink-�---- --`--- --`---- ----- Water_Softner ---- ---�--- -------- ---- <br />� Disposal I_ Wet Bar <br /> -------------1 --- ---- ----- ----- ----------- ---- ---�---- -------- ----- <br /> Dishwasher Sump Pump <br /> Sillcocks M3sc. (List) <br /> Floor Drains <br /> ������������� ����� ���r�� ������� ������ ������������� ���� ���.»��� ���������� ����� <br /> ititalralt*air�r�tairtk�lr*ie*�ktirtkf@�k*�htk�kflr�Fat�lrnititaktk**tkit*akdt**tk*drak�le�t�4�lr�k�r*tkak**it***akit�r�lcak*irtittit*air**akit* <br /> 1. Fiutnre Fee The minimum permit fee is $30.00 $ <br /> Compute number of fixtures x $8/fixture ��� � p� <br /> x $5/fixture reset <br /> 2. State Snrcharge $ .50 <br /> 3. Posta.ge � Handling (Only mail-in applications) $ 1.50 <br /> 4. TOTAL PBRMIT FEE (add lines 1-3 above) $ <br /> *************************************************************************** <br /> The undersigaed hereby applies to the City of Orono for issuance of a Plumbing Permit, <br /> agreea to do all work in atrict accordance with the ordinances of the City and the <br /> regulations of the State of Minnesota, and certifies that al 1 statements made on this <br /> application are complete, true and correct. <br /> Signature of Applicant: Date: � �� F <br />