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�CITY OF ORONO APPLICATION FOR PLUMBING PERMIT <br /> ox 66 (1335 So Brown Rd) <br /> � Crystal Bay, MN 55323 <br /> *************************************************************************** <br /> General Instrnctions <br /> 1. You may apply for plumbinq 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 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. All work must be inspected before it is covered. Call 473-7357. <br /> 24 honr notice required. <br /> *************************************************************************** <br /> JOB SITE ADDRESS: � L �J j� C fr ► r�,q h/ rC cQ . <br /> Occupancy Type: f�Residential Commercial <br /> OWNER'S NAME: �c .�r �1/�.I S c� •� Phone No. : <br /> Mailing Address: City: <br /> CONTRACTOR'S NAME: G Ii�F'� F9���*^� -�- ��,.,�s��,.•.:, Bus. No. : i,/7 3 -- %�S 7 <br /> Mailing Address: � cg N�,, �?,9yry City: �,,.�.o-� ,,�.},� Zip: r�s- 1i� <br /> Master Plumber's State License No. : M iZ /� 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 /> ------------- ---- ----a----- ---T---- ------ ------------ ---- ----�---- -------- ---- <br /> Water Closet f Sewer Ejector <br /> Lavatory L Laundry Tray <br /> -- ---•----- --------- ----- <br /> Bathtub / Washer <br /> ------------- ----- ------- ------- ------ ------------- ---- --------- --------- ----- <br /> Shower 1 Water Heater <br /> ---- ----- <br /> Ritchen Sink l Water Softner <br /> -------------+----- --�----- -------- ------ ------------- --- -------- -------- ---- <br /> Disposal Wet Bar <br /> -------------1----- --_--- ------- ------ ------------- --- --.---- -------- ---- <br /> Dishwasher Sump Pump <br /> Sillcocks Misc. (List) <br /> Floor Drains <br /> ������������� ����� ���i���� ���r����� ������ ������������� ��.�� ���r`��� ���������� ����� <br /> *************************************************************************** � <br /> 1. Fixture Fee The minimum permit fee is $30 .00 $ <br /> Compute number of fixtures x $8/fixture <br /> x $S/fixture reset <br /> 2. State Surcharge $ .50 <br /> 3. Postage � Handling (Only mail-in applications) $ 1.50 <br /> 4. TOTAL PBRMIT FEE (add lines 1-3 above) $ <br /> *************************************************************************** <br /> The undersigned hereby applies to the City of Orono for issuance of a Plumbing Permit, <br /> agreea 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: ��� �`--�-T-� Date: 2- � 5' �— <br /> � 7 / <br /> T <br />