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�` '�`3� � <br /> � 4 CITY OF ORONO APPLICATION FUR. PLUMBING PERMIT <br /> � � Box 66 (1335 So Brown Rd) <br /> 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 until 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 2��]�din� permit must <br /> be obtained. �+ '�C��!� <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 SITE ADDRESS: �Cj�j �-}t'{L,� E'}�1 r y�i.4 4-`'i � � <br /> Occupancy Type: Residential Commercial <br /> OWNER'S NAME: �i�,� -{-� ��� m 1(;� Phone No. : _�-{�Q - G$�}� <br /> Mailing Address: (��j J-f aC�.hPrn.i l r(I City: _ Lrm�, L-(,t- , <br /> CONTRACTOR'S NAME: _ �C�, Bus. No. : ���-����� <br /> Mailing Address: G � � � � City: ������ Zip: ���— <br /> Master Plumber's State Licens No. : City Cert. No. : <br /> *********************************************************,r***************** <br /> PLUMBING FIXTURE SCHEDULE <br /> (Show number of fixtures of each type on each floor) A <br /> FIXTURE TYPE BSMT 1ST FLOOR 2ND FLOOR OTHER FIXTURE TYPE BSMT 1ST FLOOR 2ND FLOOR OTHER <br /> ------------- ---- ---�----- ---T----- ----- ------------ ---- --------- --------- ----- <br /> Water Closet Sewer Ejector <br /> Lavatory Laundry Tray <br /> Bathtub Washer <br /> Shower Water Aeater <br /> Ritchen Sink '` _____- Water Softner � . <br /> -------------+---- --•---- ----•---- ----------- -- --�---- -------- ---- <br /> Disposal �_ Wet Bar <br /> Dishwasher--- ---- ------ ------- ------ Sump Pump --- ---- ---•---- --------- ----- <br /> -------------�---- -------- -------- ---- ----------- -- ------ -------- ---- <br /> Sillcocks Misc. (List) <br /> FloorDrains- ----- ---•--- --------- ----- ---- ---^--- ---------- ----- <br /> *************************************************************************** <br /> 1. Fixture Fee The minimum permit fee is $30.00 $ 3p, ��� <br /> Compute number of fixtures x $5/fixture <br /> x $3/fixture reset <br /> 2. State Surcharge $ .50 <br /> �� �� <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 atrict 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 /> i <br /> �1 - f <br /> i <br /> Signature of Applicant: ` '�'�'�°'—~- Date: :� � " % �- <br /> CUL�.�GAN WAT�R CO -- ,. <br /> . . .t ku. . . . ' .:. <br /> . �.. . . ...... . . . . . .5't�� ' . . . . ' ' . •�`y: � . <br />