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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 you receive a permit card. <br /> 4. Work muat 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 buildinq 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 /> ********************* ***************************** ********************* <br /> JOB SITE ADDRESS: ������ � C'�S �v �i,�C��� _ <br /> Occupancy Type: �Residential Commercial <br /> OWNER'S NAME: /', {��S��" Phone No. : <br /> Mailing Address: ��3,��;�� � S�-v ����. �. City: �{ �<<, z�,, �-. <br /> / -T ' <br /> CONTRACTOR'S NAME: �' (,�VI � c "�° � y ���1 J Bu s. No. : ��.��� �S `� <br /> Mailing Address: � " � �, - City: f�(�l/L 1 ' Zip: "=S:���� <br /> Master Plumber's State License o. : - ;� ��y 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 OTAER <br /> ------------- ---- ----+----- ---T----- ------ ------------- ---- ----�--- --------- ----- <br /> Water Closet �_ / Sewer E ector <br /> ------------- �f- ---—--- ---- --- ---- ------J---- -- --•---- ------- ---- <br /> Lavatory / Laundry Tray <br /> 1 <br /> Bathtub Washer <br /> ------------- ----- ------- ------- ------ ------------- ---- ---^----- --------- ----- <br /> Shower / __-_- water Heater <br /> ------------- •�--- --•---- ------ ----------- --�---- ------- ---- <br /> Ritchen Sink � Water Softner ° <br /> -------------+---- ------- -------- ----- ----------- -- ------- -------- ---- <br /> Disposal I_ Wet Bar <br /> -------------1 ---- ------ ------- ------ ------------- ---- ---�---- --------- ----- <br /> Dishwasher___I_ Sum Pum <br /> --------- 1 --- --- -- --�--- ---- --p----p--- -- ------ -------- ---- <br /> Sillcocks Misc. (List) <br /> Floor Drains <br /> *************************************************************************** <br /> l. Fixture Fee The minimum permit fee is $30.00 $ ��� �C J <br /> Compute number of fixtures x $5/fixture <br /> x $3/fixture reset <br /> 2. State Surcharge $ .50 <br /> ti <br /> ' 3. Postage & Handling (Only mail-in applications) $ 1.50 <br /> .�� � :_"'� <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 atrict 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 correc�t. , � s <br /> / <br /> ��%� �=-�� � ��� � <br /> Signature of A�;plicant: -�'"'�� _ Date: <br /> , -; , <br /> ; s .,;- -� <br /> , ;�, , _ , �:��- <br />