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� <br /> CITY OF ORONO ; ,( �j 11PPLICATION FOR PLUMBING PERMTT <br /> Box 66 (1335 So Brown Rd) � C"�� <br /> Crystal Bay, MN 55323 ' � <br /> *************************************************************************** <br /> General Instructions <br /> 1. You may apply for plumbing permits by mai.l or in person at the City offices. <br /> 2. Mailed in applications are subject to the postag and handling fees shown below. <br /> Permit cards will be sent by return mai.l the same d�y the application is received. <br /> 3. Permits are not valid until you receive a permit cazd, <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 involve� , 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 required. <br /> ********************************************** **************************** <br /> JOB SITE ADDRESS: 1� (� � � <br /> Occupancy Type: Residential C mmercial <br /> OWNER'S NAME: Pho e No. : ��fj� <br /> Mailing Address: � City: <br /> CONTRACTOR'S NAME: -C�u s. No • S, "'f�� <br /> Mailing Address: �� ' � � City: Zip: ` � <br /> Master Plumber's State License No. : � �" r City Cert. No. : <br /> ************************************* ******** **************************** <br /> PLUMBING FIXTURE SCHE: ULE <br /> (Show number of fixtures of each ty e on each floor) <br /> FIXTURE TYPE BSMT 1ST FLOOR 2ND FLOOR OTHER FIXTURE T3PE BSMT 1ST FLOOR 2ND FLOOR OTHER <br /> _____________ ____ ___1___._� __._T_____ �.___`_ _________�__ _�_._ _�_��-____ ______��� ��___ . <br /> YJater Closet _ + _� __--�_ 1- �Sewer E ectorl_ 1- �_ j- <br /> J <br /> ------------- ---- --- ----� ----- -------------j ----� --�----- --------L ---- <br /> Lavatory � Laundry Tray � <br /> Bathtub Washer <br /> ------------- -----�-------- ------- ------ ------------ ---- ---�----- --------- ----- <br /> Shower ------ Water Fiea er � <br /> --------------�----- --•----- --—---- --------- --- ---- ---•----- --------- ----- <br /> Ritchen Sink ' ' --___- Water_Sof ner <br /> -------------�---- -•---- ------ --- --�----- -------- ---- <br /> Disposal I- Wet Bar <br /> -------------1 --- ---- ----- ---- --------�-- -- --•---- --------- ----- <br /> Dishwasher I- Sum Pum <br /> -------------1 ---- -------- -------- ------ ---p----p-�--- ---- ------ ---------- ----- <br /> Sillcocks Misc. (Li�t) <br /> ------------- ----- ---•--- ----•---- ------ ---------�--- ---- ---^—--- ---------- ----- <br /> I'loor Drains <br /> ************************************************************************��** <br /> l. Fixture Fee The minimum �ermit fee is $30.00 $ <br /> Compute number of fixtures x $8/fixture <br /> x $5/fixture reset , <br /> 2. State Surcharge �' ��� � ,�"��� $ .5 0 <br /> i ,� ��, <br /> 3. Postage b Handling (Only mail-in applicat.ions) $ 1.50 <br /> 4. TOTAL PERMIT FEE (add lines 1-3 above) $ <br /> ********************************************* ***************************** <br /> The undersigned hereby applies to the City of Orono or issuance of a Plumbing Permit, <br /> agrees to do all work in strict accordance with th ordinances of the City and the <br /> regulations of the State of rfinnesota, and certi.fie that all statements made on this <br /> application are complete, true ect. <br /> � <br /> , .�'����` <br /> Signature of A�:plicant: Date: <br /> �/� 9 <br />