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12/21/2011 13:41 7637809681 PLU BING SERUICES IN PAGE 03 <br /> ;�Q�,, City of Orm�o �'nR CT['Y U5E ON,t,,Y <br /> O. 4 �.V.B�x ae uato�t000ivcd; r.crmit�1 _,_ <br /> ryq;.;,,,, 2750 Kallcy P;�rlcwny <br /> � ,��1�-;�,'�. t Crystal L3�y,�iN 55323 APproved By� Amount S: <br /> « '{�!��a��;�;j�o`-� (9,52}249•4G00—Muin <br /> �!ss!�' (952)249-4ti1 G—Fax <br /> CrTY OF O:ROZVO PLUMSING PERM.iT <br /> (l�ll Cu�urr,crcial Permits Muct be Approveu . tlic 5iate P�ior to City,Approval) <br /> p�.�t..�://ra�w�v.�11i.��an.+���,��/(''4:;f.�l')fd"�r�/ � 1urt�l�.E�rno-evso > >. �df <br /> GENERAL 1.NFORMA1"ION <br /> 1. You may flpply for plurnbin�pennits by mail or in erson�lt the City of�ces. Applications will bc <br /> r�vir.wr..d and a permiC rvi11 Ue ieeuod within two wo Icing days. <br /> 2. Permit cflrds will l�e settC by return mQil A:f�cr a revie v is completed. PERMTTS A.RE NOT <br /> VAL.ID UNTTi YOU R�CEIVF,A.P�RM1T, WO. K M ST NOT B� .iN UNT.iL TT-iT <br /> P�RMTT , �ip 1.5 pOSTTn ON T.HE JOB SLT. . <br /> 3_ Plumbing penmits m�y bc issued ONLY to licensed lumbing conttActors and to property ow��ers <br /> residing in the dwelling. <br /> 4. Whcn any new cons�ruction or remodchn��s imolv d,a sepa.ro.tc buiidin�;perniit must be <br /> c�btAincd. <br /> 5. nll work must Ue done in�ccordance with 5t�te Co TCquircment,5, <br /> 6, A.II work mtitsl bc rospected and air testecl.bcfotc it is covcred, Call(9S2)249-460(,l. <br /> (24-4$hour uoCice requircd) <br /> --.. <br /> TYQC OF PER T <br /> Chcck Al:l.That A ly) <br /> �E�csidc��tial ❑Commcrcl.Al(Approva.l Rec�tiircd) <br /> [] New ❑Additional ❑ [i� lirs ,�l�eplAcc <br /> ❑ r„A.cccssacy Snvctu�-c? <br /> �`You will need arior aporoval and may n¢ed 1;;,�,�:1?,(p Orono City Code, Chapte.r 78,Article TV) <br /> Job Site/Uwner lntor��nation: <br /> Sxie Address: —71 D� ���51�; �� <br /> Ownez; �U��-�' Mailin Addr.ess: _��Y1h� <br /> City: Zip: _. . <br /> T-�o.me Phone: Altenta Phonc: <br /> Coatractor Infor..mat.ion: <br /> Contractor: ��1��M(�1�C� 5��2i�1(.�S Co�atacc Person: _ A?(,�' <br /> Acicl.ress: �3 t I`� 51��t�1'�-� (r�Statc B r�d#: �`�]�I'� <br /> City: �'� ���' zip S-��bZ Exp9zati n Uate: � Z r j� �'" �i� <br /> PhOrie;'L��'� '����Z'� Alt�rnat Phone: <br /> � Insura�xc —Curr.ent: <br /> 1 <br /> � ��� ' � <br />