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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 appl.ication 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 must <br /> be obtained. <br /> 7. All work must be done in accordance with State Code requiremetits. <br /> 8. All work must be inspected before it is covered. Call 473-7357. <br /> 24 honr notice reqnired. <br /> ************************,t************************************************** <br /> JOB SITE ADDRESS: �s3"� G"'c-� `r �v�.� �°,� I--z <br /> Occupancy Type: X Residential Commercial <br /> OWNER'S NAME: vtf rc �.;5 � Phone No. : <br /> Mailing Address: ,,z,,..�.;_ City: <br /> CONTRACTOR'S NAME: Sfl /�R PL f, �/ b � �'�-� Bu s. No. : ��y- j 5 � � <br /> Mailing Address: �/! y � -- �� ��L S � City: rvJ;/LS Zip: 53-y0 v <br /> Master Plumber's State License No. : 1�37�, .-•-t 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 1 Sewer E ector <br /> -------------�----'i---—---- ---- ---- ------ -------]----- --- ---•---- --------- ----- <br /> Lavatory Laundry Tray <br /> Bathtub Washer <br /> Shower Water Heater <br /> Ritchen Sink j -___-_ Water Softner <br /> ------------�---- ------- ----•---- ----------- -- ------- ------- ---- <br /> Disposal I_ Wet Bar <br /> -------------1 --- ------ ----- ---- ----------- -- --�---- -------- ---- <br /> Dishwasher ' Sump Pump <br /> Sillcocks Misc. (List) <br /> Floor Drains <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 /> � <br /> 2. State Surcharge $ .50 <br /> ` 3. Postage & Handlinq (Only mail-in applications) $ 1.50 <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 strict accordance with the ordinances of the City and the <br /> ¢ <br /> regulations of the State of Minnesota, and certifies that all statements made on this <br /> application are complete, true and correct. <br /> �� � <br /> Signature of Applicant: ���--� � Date: ���C�- � <br /> ; _ _.,- <br /> : ; :,;�: <br /> ;� s�. �;,,;� ;E� <br /> , .f .., . .., . . . . . <br />