Laserfiche WebLink
' CiTY OF ORONO aZ� ;) APPLICATION FOR PLDMBING 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 /> ; <br /> ; Permit cards will be sent by return mail the same day the application is received. <br /> � 3. Pe�nits 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 requirements. � <br /> 8. A1 1 work must be inspected before it is covered. Call 473-7357. <br /> 24 hour notice required. <br /> *************************************************************************** i ' <br /> JOB SITE ADDRESS: ` <br /> Occupancy Type: !/ Residential Commercial <br /> OWNER'S N�1ME: � ��� Phone No. : <br /> Mailing Address: ✓ City: <br /> / .-�- ` 'Z—" <br /> CONTRACTOR'S NAME: /�{ , ,: n/ �'�,��'f"1b L�<a Bu s. No. : J '� ""� <br /> Mailing Address: ,;�L. ;� so i.H//' ,�,�<,, ,�' City: ,,yy�5 Zip:�/E <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 /> ------------- --- ----a----- ---T----- ------ ------------- ---- ----�---- --------- ----- ` <br /> Water Closet � Sewer Ejector � ',,� <br /> . ;: <br /> Lavatory � Laundry Tray <br /> ------------- ---- - ---- --- ---- ------ --- -- - <br /> Bathtub r Washer / <br /> ------------- ----- --—---- ------- ------ ------------- ---- --------- --------- ----- <br /> Shower Water Aeater <br /> Ritchen Sink- ----- �•----- --`---- ------ Water Softner ---- ---•----- --------- ----- _ <br /> -------------�----- --�----- ------- ------ ------------- ---- --------- --------- ----- <br /> Disposal I- Wet Bar � <br /> --------------� --- ---- ----- ---- ------------ --- ---�---- --------- ----- <br /> Dishwasher __�_ Sum Pum ' <br /> ----------- --- ---•-- --� -- ---- --P----P--- --- ------- ---------- ----- <br /> Sillcocks Misc. (List) <br /> Floor Drains � ; <br /> , ,,.: <br /> ------------- ----- ---�---- --------- ------ ------------- ---- --------- - <br /> --------- ----- �, ._ <br /> *************************************************************************** <br /> 1. Fixture Fee The minimum permit fee is $30.00 $ i <br /> Compute number of fixtures x $5/fixture <br /> x $3/fixture reset <br /> 2. State Surcharge $ .50 � 1 <br /> 3 . Postage & Aandling (Only mail-in applications) $ 1.50 � < <br /> 4',, <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 /> regulations of the State of Minnesota, and certifiea that all statements made on this � ' <br /> � : <br /> application are complete, true and correct. <br /> ; � <br /> � <br /> Signature of A�plicant: Date: i �', <br />�: i" , <br />