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CITY OF ORONO APPLICATION FOR PLUMBING PERMIT <br /> ! Box 66 (1335 So Brown Rd) <br /> k 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 application is received. <br /> � 3. Permits are not valid un�il 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 /> �, <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 hour notice reqnired. <br /> ********************************************** �************************* <br /> JOB SITE ADDRESS: ���� -' .� ^ <br /> Occupancy Type: � Residentia Commercial ' . <br /> OWNER`S NAME: �� .�� G Phone No. : ��— u�E�� <br /> Mailing Address: S�S n �� � ity: "� � <br /> CONTRACTOR'S NAME: ��� ��,�„��� Bu s. 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 /> ------------- --- ----+----- ----r----- ------ ------------- ---- ----�----- --------- ----- <br /> Water Closet-� �- / ___-- Sewer Ejector <br /> Lavatory Laundry Tray <br /> ------------ --- --—---- --�---- ------ ------------- ---- ---•----- --------- ----- <br /> Bathtub _ Washer <br /> ------------- ----�------- --�---- ----- ------------- ---- ---^---- --------- ----- <br /> Shower �. Water Heater / <br /> --------------�---=- --•----- ------- ------ ------------- ---- ---•----- --------- ----- <br /> Kitchen Sink 'I / Water Softner <br /> -------------1- -�--•----- ------- ------ ------------- ---- ---•----- --------- ----- <br /> --- - <br /> Disposal / Wet Bar <br /> -------------1---- --_--- ------ ----- ------------- ---- ---.---- --------- ----- <br /> Dishwasher I_ Sump Pump <br /> -------------1 --- ---- -- ------- ----- ------------- ---- ------- ---------- ----- <br /> Sillcocks Misc. (List) f` � <br /> ------------ ---- --•--- --------- ------ ------------- ---- ---^- --- ---------- ----- �' ? <br />� Floor Drains <br /> *************************************************************************** <br /> 1 . Fixture Fee The minimum permit fee is $30.00 $ <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) $ <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 /> �� '' .2��� � � <br /> Signature of Applicant: r ��' � ,,� l��^�z��--� Date: ��C �� � � <br />