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����� � <br /> r 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 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 muat <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 required. <br /> *********************************,****************************************** <br /> JOB SITE ADDRESS: <br /> Occupancy Type: Residential Commercial <br /> OWNER'S NAME: ��;' . Phone No. : <br /> Mailing Address: City: <br /> CONTRACTOR'S NAME: Bus. No. : . <br /> Mailing Address: City: Zip: <br /> Master Plumber's State License No. : 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 OTHER <br /> ------------- ---- ----+----- ---T----- ------ ------------- ---- -------- ------- ---- <br /> Water Closet Sewer Ejector <br /> ------------- ---- -------- ---- ---- ------ ------------- ---- ---•----- --------- ----- <br /> Lavatory ,` Laundry Tray <br /> ------------- ---- ---—---- -------- ------ ------------- --- ---•1,--- ------- ---- <br /> Bathtub �' " Washer <br /> ------------- ----- ------- ------- ------ ------------ --- --- r------ ------- ---- <br /> Shower Water Aeater � <br /> ---------- -�-- --_.----- --------- ----- <br /> Ritchen Sink ' � Water Softner <br /> ------------- ---- ---�---- --------- -••--- <br /> Disposal wet Bar <br /> ------------- ----- -------- ------ ------ ------------ --- --1--- -------- ---- <br /> Dishwasher Sump Pump '7 <br /> ---- ---- ------- ---------- ----- <br /> Sillcocks MisC. (List) <br /> ---------- ---- -------- ---------- ----- <br /> Floor Drains <br /> - ----------- ----- ---�---- -----�-- ------ ------------- ---- --------- ---------- ----- <br /> ***********,t***********************************tr**************�}************ - <br /> 1. Fixture Fee The minimum ermit f ee is $30.00 $ �`�> ,�(�,�.�,Z� <br /> Compute number of fixtures�:fiti 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) $ "(p~���� <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 /> Signature of Applicant: Date- <br /> ( <br />