Laserfiche WebLink
' `r✓�'a <br /> � CITY OF ORONO APPLICATION FOR PLUMBING PERMIT <br /> Box 66 (1335 So Brown Rd) <br /> Crystal Bay, MN 55323 <br /> *************************************************************************** <br /> General Iastructions <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 recR,iyEd. <br /> 3. Permits are not valid until pou receive a permit card. <br /> 4. Work must not begin unless the permit card is available on the j�E�'1.te� 4 °��'?�'-' <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. AI1 work must be inspected before it is covered. Call 473-7357. <br /> 24 honr notice reqnired. <br /> ***************************.** ** ****** ******* ** *********************** <br /> JOB SITE ADDRESS: I��T' �l.r��f[Cl`r 7'LC��/� /L G'l <br /> Occupancy Type: ;( Residential Commercial <br /> n ��"I � � PhonE �70. . �-t' ! �"' t' ���"� <br /> �Gd�'7�R'S �TAME: ! J� ' . <br /> Mailing Address: �;��-/ / i�v �'Ur�/�'G� City: G fGs��� ;"S3�r/_ <br /> CONTRACTOR'S NAME: Bus. No. : � '7.� UC� <br /> Mailing Address: ir���=k� (�. ��ac•, r.�.� r��c� City: J�/j f !.� Zip: �S:��S <br /> Master Plumber's State License No. : City Cert. No. : <br /> *************************************************************************** <br /> PLUMBING FIXTIIRE SCHEDIILE <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 /> __���_����__� -!-_��� �_=T��__� ��_��� ���_��__� ���� ���_�_��� _����_��� <br /> ��� <br /> Water Closet _---_ Sewer Ejector <br /> _____________I====�________ __ _ ____ _ _____________ ____ ___._____ _________, _____ <br /> Lavatory � ' Laundry Tray ! <br /> -------------�----{--—---- -------- ------ ------------- ---- ---•----- ---------+------ <br /> Bathtub � Washer <br /> --------------�-----` ------- -- --- ------ ------------- ---- --------- --------- ----- <br /> Shower I i Water Heater <br /> --------------�-----�--•----- ------- ------ ------------- ---- ---•----- --------- ----- <br /> Ritchen Sink ; 1 Water Softner I <br /> ------------ ----�-------- -------- ------ ------------- ---- --------- --------- ----- <br /> Disposal � Wet Bar , <br /> -------------1---- -_-- ----- ------ ------------ ---- ---.---- --------- ----- <br /> Dishwasher ! Sump Pump <br /> -------------1----- -------- --------- ------,------------- ---- ------- ---------- ----- <br /> Sillcocks Misc. (List) <br /> Floor Drains <br /> ------------- ----- ---�=--- ---�----- ------ ------------- ---- -------- ---------- ----- <br /> ****************************************,t*****************************,t**** <br /> l. Fixture Fee The minimum permit fee is $30.00 $ �(�i.(� <br /> Compute number of fixtures x $8/fixture <br /> x $5/fixture reset <br /> 2. State Surcharge $ .50 <br /> 3. Postage � Handlinq (Only mail-in applications) $ 1.50 <br /> 4. TOTAL P$RMIT FEE (add lines 1-3 above) $ J:� �.�.J <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 A�plicant � , ���' �f-•'� Date: )- '" ,5 �`% 1- <br /> CULLIGA�4 WAT�R CONDI�i�vi�ii'vG <br />