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CITY OF ORONO APPLICATION FOR PLUMBING PERMIT <br /> 3ox 66 (1335 So Brown Rd) <br /> Crystal Bay, MN 55323 <br /> *************************************************************************** <br /> General Inatrnctions <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 yon receive a permit card. <br /> , 4. Work muat 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 muat be done in accordance with State Code requirements. <br /> B. All work must be inspected before it is covered. Call 473-7357. <br /> 24 honr notice reqnired. <br /> *********,k******,t****************rt********,t*********,k*,k********,k*********** <br /> JOB SITE ADDRESS: .,,�,�v „�v �ia�,,,-. ,�� <br /> Occupancy Type: .s- Residential Commercial <br /> OWNER'S NAMS: ��P/�.� Phone No. : y7s" _ �g��/ <br /> Mailing Address: _ ,��.,e City: f�,..4 <br /> CONTRACTOR'S NAMB: �,.�1 Q,,,� ��g� �-,,, Bus. No. : ��6• „3�,�-� <br /> Mailing Address: �gy�� /��,C,���oa� .�` City: ��„� �y;�s Zip:��i3,� <br /> Master Plumber's State License No. : � ��o,�' 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 /> ------------- ---- ----+----- ---T----- ------ ------------- ---- ----�---- -------- ---- <br /> Water Closet � Sewer Ejector <br /> ----- ------------- ---- ---•----- --------- ----- <br /> Lavatory � Laundry Tray <br /> - ------ ------------- ---- ---•—---- --------- ----- <br /> Bathtub / Washer <br /> -- ------ ------------- ---- ---^-�--- --------- ----- <br /> Shower � Water Heater <br /> --- ------ ------------- ---- ---•----- --------- ------ <br /> Ritchen Sink Water Softner <br /> ------ ------------- ---- ---�----- --------- ----- <br /> Disposal Wet Bar <br /> ------------- ----- ------- ------- ------ ------------- ---- <br /> ---•---- --------- ----- <br /> Dishwasher Sump- Pump <br /> -- ------ ------------- ---- ------- ---------- ----- <br /> Sillcocks Misc. (List) <br /> ---- ------ ------------- ---- ----- --- ---------- ----- <br /> Floor Draina <br /> ������������� ����� ���i���� ���a����� ���r�� ������������� ���� ��.�.��.��� <br /> *************************************************************************** • <br /> l. Fixture Fee The minimum permit fee is $30.00 $ �r� • � � <br /> Compute number of fixtures � x $8/fixture <br /> x $5/fixture reset <br /> 2. �tate Surcharge $ .50 <br /> 3. Postage � Handling (Only mail-in applications) $ 1.50 <br /> 4. TOTAL PERMIT FEE (add lines 1-3 above) $ f/,�' v v <br /> *************************************************************************** <br /> The undersigned hereby applies to the City of Orono for issuance of a Plumbing Permit, <br /> agrees to do all work in atrict accordance with the ordinances of the City and the <br /> regulationa of the State of Minnesota, and certifies that all statements made on this <br /> application are complete, true and correct. <br /> � <br /> Signature of Applicant: _��°� � �G� Date:�/�„���`�- <br />