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� T �PPLIC�TION �OR PLU�SBIVG PERMIT <br /> C�TY OF ORONO <br /> Box 66 (1335 So Brown Rd) <br /> Crystal Bay, MN 55323 <br /> ******************************j***�*************************************** <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 shown below. <br /> Permit cards will be sent by return mail the same da1 the application is received. <br /> 3. Permits are not valid until yon 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 reqnired- <br /> **********,t,t********* *********** ********* ;r*** ************************* <br /> JOB SITE ADDRESS: � �e-�� GX-�' `����"� <br /> . . Occupancy Type: Residential Commercial <br /> OWNER'S NAME: �'C \C�l.�\ �'_ ``�� Phone No. : <br /> Mailing Address: City: ��Y�� <br /> � '��a -�3�1� <br /> CONTRACTOR'S NAME: �C � ��� Bus. N . . <br /> Mailing Address: - � N, City: � . Zip: �`� <br /> Master Plumber's State License No. : Cit y Cert. No. : <br /> *************************************************************************** <br /> . PLIIA�ING FIXTIIRE SCHEDIILE <br /> � (Show number of fixtures of each ty�e on each floor) <br /> FIXTURE TYPE BSMT 1ST FLOOR 2ND FLOOR OTHER FIXTURE TYPE BSMT 1ST FLOOR 2ND FLOOR OTHER <br /> � - ----^---- ------ <br /> _���__�����__ ���^_�_-7�_�_� T����� �_ <br /> , r --- TISewer Ejector I r <br /> S:ater Closet � X I 1 <br /> �������������1����'����.���� ����'� �������{�������������y���� ���.�����T��������� ����� <br /> Lavatory ' Laundr Tra I � _ <br /> � Y Y <br /> ------------ !-�- ------- --�---- ------ ------------- �----y---.----- ---------�---- <br /> - � ` �1 T <br /> , ; � � <br /> Bathtub I � Washer <br /> ----�-- ------ ------------- ---^-----' ----- <br /> . ������1�������� ��� r <br /> ������� ����� , <br /> Shower Water fieater ___ <br /> . - i k- � --�---- I ------�------ -------------�---- ---�-----�---------�-- <br /> _ --� Ritchen-Sink-__-------�-----I-------------- Water-Softner � ---I---------i ---------I ----- <br /> 'I � Wet Bar 1 ` I <br /> Disposal-----�-----I ------ ------- ------ -------------t----i---•---- I ---------�----- <br /> � I <br /> � � <br /> Dishwasher i SumP Pu�P <br /> + ------- ---- ------- ---------- ----= <br /> 1-----�----•--- -----------�------ ------ <br /> ---------- � I <br /> Sillcocks Misc. (List) <br /> � Floor Drains <br /> ---- ------ ------------- ---- -- <br /> *************************************************************************** <br /> l. Fixture Fee The minimum permit fee is $30.00 $ <br /> Compute number of fixtures x $5/fixture <br /> x $3/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) S <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 certifies that all statements made on this : <br /> application are complete, true and correct. ; <br /> - i <br /> , i <br /> -� � � Date: � �� �� � � 1 'i <br /> Signature of Applicant: � <br />�: <br />