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t ' <br /> ' ' � <br /> �������4 <br /> ��� 2 6 200� <br /> Box 66 (2O7R0 Ke011ey Parkway) APPLICATION FOR PLUMBING R�R�V[�'�-o��Nd <br /> Crystal Bay, MN 55323 <br /> GENERAL INFORMATION <br /> 1. You may apply for plumbing permits by mail or in person at the City offices. <br /> 2. Permit cards will be sent by return mail after a review is completed. PERMITS ARE NOT VALID LINTIL YOU <br /> RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS POSTED ON THE JOB <br /> SITE. <br /> 3. Plumbing permits may be issued ONLY to licensed plumbing contractors and to property owners residing in the <br /> dwelling. <br /> 4. When any new construction or remodeling is involved, a separate building permit must be obtained. <br /> 5. All work must be done in accordance with the State Code requirements. <br /> 6. All work must be inspected and air tested before it is covered. Call (952) 249-4600. 24-hour notice required. <br /> Instructions Complete all items on this application. i,ompute the permit fee. Sign and daie the <br /> certification. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have questions, <br /> call (952) 249-4600. <br /> Please check one: New Addition Repair Replace <br /> ,�1 Residential Commercial <br /> JOB SITE: /�S �'OLvf/r/ �1l�cJ ,�r�- , �,��'�✓C� , /�it/ Zip: <br /> Owner's Name: �'�lli�� �itP,e-� Telephone 1Vumber: �.��-�3? o?l�/ <br /> Mailing Address: sAin City: Zip: �i 53��3 <br /> Contractor's Name: f.��f2se�/� -Asc�'�// / C- Telephone Number: 7G.3 y��-3/�-/ <br /> Mailing Address: S%/s jrvdUsi,E'�r�G S�` � City:/'�Ild�� O�Airt-� Zip: 3rS35� <br /> PLUMBING FIXTURE SCHEDULE <br /> FIXTURE BSMT 1 ST 2ND OTHER FIXTURE BSM 1 S 2ND OTHER <br /> TYPE FL FL TYPE T T FL <br /> FL <br /> Water Closet Floor Drains <br /> Lavato Sewer E'ector <br /> Bathtub Laund Tra <br /> Shower Washer <br /> Kitchen Sink Water Heater <br /> Dis osal Water Softener <br /> Dishwasher Wet Bar <br /> Sillcocks Misc list ,� <br /> ,����- . � <br /> �'3.,,.,��a►,��� <br />