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CITY OF ORONO APPLICATION FOR PLUMBING PERMIT <br /> Box 66 (1335 So Brown Rd) <br /> Crystal Bay, MN 55323 <br /> *�************************************************************************* <br /> General instructions <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 pou 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 hour notice reqnired. <br /> ********************************** * **********�* ************,t*********** <br /> JOB SITE ADDRESS: � -_-��' ,� : ��� �,, , � <br /> Occupancy Type: Residential Commercial <br /> � � � <br /> OWNER'S NAME: ��dc ��.✓���� hone No. : �'��" �,,� � � <br /> o, <br /> Mailing Address: �`��� � ,��� � City: ���;����� <br /> �:� CONTRACTOR'S NAME: '�ls''��� . � �'�� ��^- �� Bus. No. : � � `� ���� <br /> Mailing Address: < � .8�`4-� City: ���,�,� , ���;;���< <br /> �' Master Plumber s State License No. : � City Cert. No. : <br /> ***********************************************************,t*************** <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 /> �•` 4�ater Closet �_ Sewer Ejector j <br /> , ------------ --- -------- ---- ---- ------ ------------- --- ---•----- ---------+------ <br /> Lavatory Laundry Tray <br /> - -- --------- ----- <br /> Bathtub Washer <br /> � <br /> ------------- ----�------- ------- ------ <br /> ------------- ---- --------- --------- ----- <br /> �; Shower i Water Heater <br /> --------------�-----�---�----- ------- ------ ------------ ---- ---•----- --------- ----- <br /> ° Ritchen Sink ' - Water Softner <br /> ' -------------�----- ------- -------- ----- ----------- --- ---�---- -------- ---- <br /> ' Disposal Wet Bar <br /> � -------------1----- --_--- ------- ------ ------------- ---- ---.---- --------- ----- <br /> Dishwasher Sump Pump <br /> ------------- ----- ----•--- --------- ------ ---`--------- ---- ------- ---------- ----- <br /> � Sillcocks ' (Li t <br /> ------------- ----- ---•--- ----•---- ------ - • , <br /> - - --- ------- ---------- ----- <br /> � Floor Drains <br /> � � <br /> --------- ----- ---�----- --------- ------ --------- --- ---- ---�---- ---------- ----- <br /> ' *************************************************************************** <br /> � l. Fixture Fee The minimum permit fee is $30.00 $ ��• :fi�j <br /> Compute number of fixtures x $5/fixture <br /> �` x $3/fixture reset <br /> ,, <br /> � <br /> � 2. State Surcharge $ .50 <br /> �' ` <br /> � 3. Postage � Handling (Only mail-in applications) $ }�p <br /> �' 4, TOTAL PERMIT FEE (add lines 1-3 above) $ ������ <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 certffies that all statements made on this <br /> application are complete, true and correct. <br /> � �� <br /> � <br /> Signature of Applicant: -s Date: � �- � �•���� <br /> � <br />