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�ITY OF ORONO APPLICATION FO� PLIIMBING PERMIT <br /> Box 66 (1335 So Brown Rd) <br /> Crystal Bay, MN 55323 <br /> *************************************************************************** <br /> General Instrnctions <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 ahown 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 muat 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 reqnired. <br /> ************************************************J�************************** <br /> JOB SITB ADDRESS: � � �I;�� ���.�G� G a i" C. LE <br /> Occupancy Type: Residential Commercial <br /> OWNER'S NAME a ` - c.�- �v�..� Phone No. : <br /> Mailing Address: '�, � �S- ��,S G� ' �,�^� City: ��� .� � <br /> ' CONTRACTOR'S NAME: ''�;.,6q�— ��,. �• Bu s. No. : ,� ., 3�' .5 �:� <br /> � Mailing Address: � c � City: �/'������ Zip: 3"$� <br /> Master Plumber's State License No. e '3t�'� t� City Cert. No. : <br /> *************************************************************************** <br /> PLUMBING FIXTURE SCHEDULB <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 /> -------------1---_- --_--- ------- ------ ------------- ---- ---.---- -------- ---_ <br /> Dishwasher Sump Pump <br /> --- ---- ------- ---------- ----- <br /> Sillcocks Misc. (List) <br /> ---------- ---- ------- ---------- ----- <br /> Floor Draina <br /> ------------- ----- ---�---- --------- ------ ------------- ---- -------- ---------- ----- <br /> *************************************************************************** �. <br /> 1. Fixture Fee The minimum permit fee is $30.00 $ ,�J� � �'^y <br /> Compute number of fixtures x $8/fixture <br /> x $5/fixture reset <br /> 2. State Surcharge $ .50 <br /> 3. Postage � Handling (Only mail-in applications) $ 1.50 <br /> 4. TOTAL PERMIT FEE (add lines 1-3 above) $ ��',i . .��� <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 /> regulations of the State of Minnesot and certifies that all statements made on this <br /> application are complete, true and rr ct. <br /> Signature of Applicant: �^--' Dates � '� � � � � ^ <br />