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Microsofr Word-Plumbing Pernut-Updated.doc-Plumbing_Pernut_... http://www.ci.orono.mn.us/vertical/Sites/{CBFC8FAF-C313-4854-A... <br /> J � t <br /> PLUMBING FIXTURES BEING INSTALLED <br /> FIXTURE BSMT 1 2' OTHER FIXTURE BSMT 1 2' OTHER <br /> TYPE FL FL TYPE FL FL <br /> Water Closet / / / F1oorDrams � <br /> ! <br /> Lavatory � / � Sev��er Ejedor <br /> Bathtub � / Laundry Tray <br /> l <br /> Shower � W asher <br /> Kitchen Sink ` �Vater Heater % <br /> l <br /> Disposal / VVater Softener <br /> Dish�sasher Wet Bar <br /> Sillcocks Miscellaneous <br /> — -- — -------_ —— <br /> PERI�4IT FEE CALCULATION(S) <br /> BASED OFF -2002 STATE STATUE <br /> ❑ Yes,this section applies <br /> The replacement of onh one Residential fixture or appliance that meets all three of the following <br /> requirements: <br /> 1. Does not require mod�cation to electrical or gas service. <br /> 2. Has a total cost of$500.00 or less;excludinst the cost of the fixture or appliance:and <br /> 3. Is improved,installed or replaced by the homeowner or licensed plumbing contractor. <br /> Skip next section,if this applies; Cost of Pern►it S 15.00 <br /> State Surcharge $ 5.00 <br /> h1ai1-In Fee(If Applicable) $ 2.00 <br /> Total PermitFee S <br /> (Permit Fees Continued On Neat Page) <br /> � <br /> 2 of 3 3/19/2013 1:07 PM <br />