1991-003782 (plumbing- water softener)

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,� � I-. CZTY OF ORCNO t�PPLiC�TION F PLIivLBING T�ER�;1IT Box 66 (1335 So Brown Rd) �� Crystal Bay, MN 55323 **************************************************** �***************** General Instrnctions A �'' 1. You may apply for plumbing permits by mail or in person at the City offi es�A��y 2. Mailed in applications are subject to the postage and handlin_gof�s�hown below. Permit cards will be sent by return mail the same dal the applic��k��n is received. 3. Perm.its are not valid until yon receive a permit card. 4. Work must not begin unless the permit card is available on the job site. 5. Plumbing permits may be issued to licensed contractors only. 6. When any new construction or remodeling is involved, a separate building permit must be obtained. 7. All work must be done in accordance with State Code requirements. 8. All work must be inspected before it is covered. Call 473-7357. 24 honr notice reqnired- *************************************************************************** JOB SITE ADDRESS: ��.S'..� C��O� E� S� �.- -. - Occupancy Type: �_Residential Commercial OWNER'S NAME: �o f� o T� Phone No. : � 7/- 7 v2�� ' Mailing Address• a2 � f� �' A4/�i T �i�Y= D/�iD�l0 ' CONTRACTOR'S NAME: �h l G� C d Bu s. No. : �3 3- 70�d d Mailing Address: � �a G u h t/ C �e /�G•e�-� _ City: ,Nt�r-Kf� Zip: ,t��-�j' Master Plumber's State License No. : � City Cert. No. : *************************************************************************** - PLIIP�ING FIXTIIRE SCHEDIILE (Show number of fixtures of each tyFe on each floor) � FIXTURE TYPE BSMT 1ST FLOOR 2ND FLOOR OTHER FIXTURE TYPE BSMT 1ST FLOOR 2ND FLOOR OTHER - --�----- ------------- --------- ------------- �----- ? � r -_-_ Sewer Ejector j 4:ater Closet � � � _ ! _____________y____ ________ ____ I=====_ _____________ ____ __._____ _______________ Lavatory � ' Laundry Tray i I _____________�____ _______;_______1______ _____________ i____ ___._____ _______________ - � � 1 Bathtub I � I Washer : -------------1-----=-------+-- --- ------ Water Seater--}---- ---^----- ---------r----- , . Shower------- I-------•-----I------- ------ -------------�---- ---•----- ---------=----- _ _ � ' - � I - Ritchen Sink ; ' Water Softner��_1__ � -- , ---------- -------------------------------------------- I � � i Disposal f � Wet Bar ---------y----- ------- ------ ------ ------------- ---- ---•---- ---------�----- ---- ` M I I � Bishwasher � Sumo Pump ' ----- ------------- ------- ---------- `' -------------1-------------- -------- - I � � Misc. (List) . _ Sillcocks � � _ ----�---•--- - --- ----------�---- ------- ------------- ---- I---------- ---- ---------- ---- Floor Drains � �_ L____- � _ __ ________1______1_____________1____�________�__________ *************************************************************************** 1. Fixture Fee The minimum �ermit fee is $30.00 $ 3 b •�� Compute number of fixtures x $5/fixture - x $3/fixture reset �":��`.`�';.:: $ .5 0 . -- 2. State Surcharge ` � � 3. Postage � Handling (Only mail-in applications) $ 1.50 .. . G . 4. TOTAL PERMIT FEE (add lines 1-3 above) S � � d *************************************************************************** The undersigned hereby applies to the City of Orono for issuance of a Plumbing Permit, • � agrees to do all work in strict accordance with the ordinances of the City and the ; regulations of the State of Minnesota, and certifies that all statements made on this , application are complete, true and correct. ; . ' Date: `i ' Signature of Applicant:"�—��-'�/� �� -L---- j �