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c:l•r�r vF ORONO APP4.T�*.TION FOR PLUMBING 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 peraon 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. Permfts 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. Ffien 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. 24 hour notice <br /> required. <br /> *************�t*******,t* ****** **** **** *�,t************************** <br /> JOB SITE ADDRESS: � � <br /> Occupancy Type: esi ential Commercial <br /> OWNER'S NAMS: _ �� _ Phone No. : <br /> Mailing Addr . City: <br /> CONTRACTOR'S NAME- • Bus. No..• <br /> Mailing Address: - Cit �j�—� <br /> Master Plumber's tate License No. : y� � <br /> ************************************ * ************************************ <br /> PLIIMBING FIXTIIRE SCHEDDLE <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 /> ---- ----- --------- -------- ----- -------------- -------- ----- -------- ---- <br /> Water Closet , Laundry Tray <br /> ---- -------- ----- -------------- -------- ----- --------- ----- <br /> Lavatory � Washer r <br /> -- --------- -------- ----- -------------- -------- ----- -------- ----- <br /> �' Bathtub _Water Heater <br /> ------------- ----- --------- -------- ----- ---------- -------- -L- -------- ---- <br /> Shower � Water Softner <br /> ------------- ----- --------- -------- ----- -------------- -------- ----- -------- ----- <br /> Kitchen Sink � Misc. (list) <br /> , ------------- ----- --------- -------- ---- -------------- -------- ----- -------- ----- <br /> Disposal <br /> ------------- ----- --------- -------- ---- -------------- -------- ----- -------- ----- <br /> Dishwasher <br /> ------------- ----- --------- -------- ---- -------------- -------- ----- -------- ----- <br /> ' Wet Bar <br /> ------------ ----- --------- -------- ---- -------------- -------- ----- -------- ----- <br /> Sillcocks <br /> ------------- ----- �---- -------- ---- -------------- ------- ----- ------- ---- <br /> Floor Drains / <br /> ------------- ----- -t_______ ________ -___ ___--__-____-- ---__-_ ____- ------- ---- <br /> Sump Pump <br /> ------------- -------- ----- -------------- <br /> Sewer Ejector <br /> ****************************�*** ****************************************** <br /> 1. Fixture Fee The minimum per t fee is $30.00 $ <br /> Compute number of fixtures � x $4/fixture <br /> 2. State Surcharge $ .50 <br /> 3. Postage & Handling (Only mail-in applications) $ 1.50 <br /> 4. TOTAi. PERMIT FEE (add lines 1-3 above) $ <br /> ****�r*************�*�********��r******�r*�**********,t*****�*************�**** <br /> The undersigned hereby applies to the City of Orono for issuance of a Plumbing Permit, <br /> agrees to do all work in strict �ccordance with the ordinances of the City and the <br /> ; regulations of the State of Minne ta, and certifies that all statements made on this <br /> application are complete, tru correct. , <br /> Signature of Applica � Date: � �� ,���� <br /> , _ <br />