Laserfiche WebLink
CiTY OF ORC�O � �PPLiC�TICN �OR PLU.�iBIyG PERMIT <br /> Box 66 (1335 Sa Brown Rd) « <br /> Crystal Bay, MN 55323 <br /> *************************************************************************** <br /> General Instractions <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 /> Perr.iit cards will be sent by return mail the same da1 the application =s received. <br /> 3. Permits are not valid until yon 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. AI1 work must be inspected before it is covered. Call 473-7357. <br /> 24 honr notice reqnired- <br /> *************************************************************************** <br /> JOB SITE ADDRESS: /!�Ac.��.Ber' `� �GG <br /> -. - Occupancy Type: __�___Residentia Commercial <br /> OWNER'S NAME: Phone No. : <br /> Mailing Address: City: <br /> CONTRACTOR'S NAME: ,(j%b �c � �� Bus. No. : <br /> �1 Jt S. Clty: �.� f.'ti.�.,�,�- Zip: SS3 y�/ <br /> Mailing Address: Kn � e cJ�s��.� r�-� -' <br /> , Cit Cert. No. : <br /> Master Plumber s State License No. : 2 zi5 -� Y <br /> *************************************************************************** <br />- PLIIP�ING FIXTIIRE SCHEDIII,E <br /> � (Show number of fixtures of each tyFe on each floor) <br /> FIXTURE TYPE BSMT 1ST FLOOR 2ND FLOOR OTHER FIXTURE TYPE BSMT 1ST FLOOR 2ND FLOOR OTHER <br /> ------------- --------�-----r---T----- <br /> ------------- ----^---- ------- <br /> v:ater Closet 1 ( ___ Sewer Ejector j j j <br /> _____________y___ �________�___1_ I=====_ _____________�____ ___._____ _________ _____ ; <br /> Lavatory ! I , ( _-_I_ -_ Laundry Tray � <br /> ! ------------- ----1---�----- ---------�----- <br /> ------------------=---—----i-- 1 � <br /> � � <br /> Bathtub I � � Washer <br /> --- ------ ------------- ----- ---------r----- <br /> ---- <br /> --- <br /> � - -------------1-----=-------�'-- <br /> � , I l Water &eater I ' <br /> , Shower � ---------- --- --•----- ---------� ----- <br /> " -----�----=--•------------- ------ --t- - <br /> -------- <br /> � <br /> - � Ritchen Sink ' � Water Softnerj � <br /> _ - - , ----------------------�----�---------------I-------------1----1------------------------ <br /> 1_____� . <br /> �is osal wet Bar I <br /> ---P-------- I ------ -------�------ ------------- ---- ---•--- ---------�------ <br /> _ � <br /> I ' <br /> Dishwasher � Sump Pump <br /> � ------- ---- ------- ---------- ----= <br /> 1----------•--- -------- ------ ------ <br /> ---------- � <br /> Sillcocks Misc. (List) <br /> Floor Drains <br /> --- ---�---- ---�----- ------ ------------- ---- <br /> *************************************************************************** <br /> 1. Fixture Fee The minimum Fermit 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) S ; <br /> *************************************************************************** <br /> �� lies to the Cit of Orono for issuance of a Plumbing Fermit, <br /> The undersigned hereby app Y ; <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 /> '.h��G�� Date: 7- z s-- 5'i } <br /> Signature of Applicant:�_ �� - <br />