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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 Instrnctions <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 pou receive a permit card. <br /> 4. Work muat 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 conatruction 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. <br /> 24 honr notice reqnired. <br /> *************************************************************************** <br /> JOB SITB ADDRESS: I � l-f-�� �c� S - <br /> Occupancy Type: Residential Commercial <br /> OTi�7l4ER'S NAME: Phone No. : <br /> Mailing Address: ! 5'+-ro i-�x S i-. CiLy: <br /> CONTRACTOR'S NAME: /I,:,rfl, y ; �f�. �/u�.,�.��, �, Bus. No. : 5 �T/- /;"�-�; <br />. . Mailing Address: (��1�,L� �'1�.�1;s��� 11ve. �1/, �' o City: ("�u��rr" I.-�r�iA,�,; Zip:S55��� <br /> Master Plumber's State License No. : 3�f- �"� 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----- ---�----- ------ ------------- ---- ----�---- --------- ----- <br /> Water Closet y Sewer Ejector <br /> ------------ -- --�--- --- --- ---- ----------- -- ---•---- -------- ----- <br /> Lava�.�ry � Lanndry Tr?y <br /> Bathtub � Washer <br /> Shower I Water Heater <br /> Ritchen Sink Water Softner <br />� Disposal Wet Bar <br /> Dishwasher Sump Pump <br /> Sillcocks Misc. (List) > <br /> r <br /> Floor-Drains-�----- --�----�---------�------�-------------�----+-------�----------L----- <br /> ********************************rt********************,k**********it********** a <br /> ' 1. Fixture Fee The minimum permit fee is $30.00 $ �3C%. CsG <br /> Compute number of fixtures � x $5/fixture <br /> x $3/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) $ >��,C��' <br /> � *************************************************************************** <br /> � The undereigned hereby applies to the City of Orono for isauance of a Plumbing Permit, <br /> v � agrees to do all work in atrict accordance with the ordinances of the City and the <br /> regulationa of the State of Minnesota, and certifies that all statements made on this <br /> application are complete, true and correct. ; <br /> . ; <br /> `'i7 ' <br /> Signature of Applicant: �� �--- `�-�"'�v� •�c.w Dates � - S•�Cf�,�i' <br /> � . <br />