Laserfiche WebLink
CITY OF ORONO APPLICATION FOR PLUMBING PERMIT <br /> Box 66 (1335 So Brown Rd) % <br /> Crystal Bay, MN 55323 ����� . . ' , <br /> ' ************************************************************** ************ <br /> 4+._ <br /> General Instructions �' <br /> 1. You may apply for plumbing permits by mail or in person at the City offices. : ,; <br /> ' 2. Mailed in applicatio'hs 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 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. i_: ';' <br /> �. <br /> 24 hour notice reqnired. � ! <br /> ********************************** ***************** ********************** 4 iE <br /> JOB SITE ADDRESS: �� �-5` �--��r-"-�r� "'�=--'E- , �` <br /> Occupancy Type: Reside tial Commercial ;� �,�r <br /> � � <br /> OWNER'S NAME:�z�,. ��.�G , Phone No:.: �/_5 � �/ �� <br /> Mailing Address: City: <br /> � <br /> CONTRACTOR'S NAMEs � ��s��--<__., � ��� Bus. N�4 •.-. J%� �//G ' <br /> Mailing Address: %�� City: f���"-,.��� Zip: -5_5���� <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 15T FLOOR 2ND FLOOR OTHER FIXTURE TYPE BSMT 15T FLOOR 2ND FLOOR OTHER <br /> ------------- --- ----+----- ----r----- ------ ------------- ---- ----�---- --------- ----- <br /> Water Closet l Sewer Ejector <br /> ------------ --- ---1--- ---��-- ------ ------------- ---- ---� ---- --------- ----- <br /> Lavatory Laundry Tray / <br /> ------------- --- -�---- ---�---- ------ ------------- ---- ---•----- --------- ----- ' . <br /> Bathtub % �_ Washer <br /> ------- ---- ---�--- --------- ----- <br /> ------------- <br /> �---- ------- ------- ------ ------ � <br />� Shower Water Heater <br /> ------------- ----- --�----- --------- ------ - <br /> Ritchen Sink ' � Water Softner ' <br /> -------------�-- --• --- -------- ------ ------------- ---- -------- --------- ----- <br /> Disposal - / Wet Bar <br /> -------------�- ------ ------ ------ ------------- ---- ---•---- --------- ----- <br />� Dishwasher / Sump Pump ' <br /> ------------- ----- ---�7•--- ----�---- ------ ------------- ---- -- <br /> Sillcocks �L- Misc. (List) <br /> ------------ ---- `�•--- --------- ------ ------------- ---- ---^---- ---------- ----- <br /> Floor Drains � <br /> ------------- ----- --Fa---- --------- ------ ------------- ---- ---�---- ---------- ----- . <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 & Aandling (Only mail-in applications) $ 1.50 <br /> 4. TOTAI, 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 c rrect. �� <br /> , ;�, <br /> �� � �� '�� � <br /> Signature of Applican . �---�� �1��'���� Date: ��— , <br />