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CITY OF ORONO APPLICATION FOR PLUMBING PERMIT <br /> Box 66 (1335 So Brown Rd) �, ti( <br /> Crystal Bay, MN 55323 �- � �� <br /> *************************************************************************** <br /> General Znstructions <br /> 1. You may apply for plumbing permits by mail or in person at the City offices. <br /> 2. Mailed in applications are subjec'� to the poatage and handling fees ahown below. <br /> Permit cards will be sent by re�urn �il 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 separtite 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 reqnired. <br /> ************************,t****************** * ***************************** <br /> JOB SITE ADDRESS: `� � c�� �' <br /> Occupancy Type: Resi ntial Commercial <br /> OWNER'S NAME: ) � � C Phone No. : GI �� � � <br /> Mailing Address: �'-=' c,�- City: C" " <br /> CONTRACTOR'S NAME: Bus. No. : <br /> Mailing Address: City: Zip: <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 1ST FLOOR 2ND FLOOR OTHER FIXTURE TYPE BSMT 1ST FLOOR 2ND FLOOR OTAER <br /> ������������ ��������� ���T����� ������ ������������� ���� ����r���� ��������� ����� <br /> Water Closet Sewer Ejector <br /> LavatorY----- --- ---�-- ------- ----- Laundry_Tray -� --•---- ------- ---- <br /> Bathtub Washer <br /> Shower x Water Aeater <br /> Ritchen Sink 'I -_---_ Water Softner <br /> -------------+---- -•---- ----•---- ----------- -- ------ -------- ---- <br /> Disposal I_ Wet Bar <br /> -------------1 ---- ------ ------- ----- ----------- -- --•---- -------- ---- <br /> Dishwasher I- ___-_- Sump Pump <br /> -------------1 --- -------- -------- --------- -- ----- -------- ---- <br /> Sillcocks Misc. (List) <br /> Floor Drains <br /> ������������� ����� ���i���� ���a����� ������ ������������� ���� ���r���� ���������� ����� <br /> 7k'k'�C7�1'��f*7t****'k'A'*'k*'k'k'k*7t*'J�'**'k*�'*'k'�i'k'k'k********'k'�C'k***�C**�'*�f**'�(�"k*'k'k*'�C****�'**'k�"k'k ' <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 & 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 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 /> Signature of Applicant: � ��rc.�Lt�� Date: �Q -� ��'� <br /> ' . . . T i ' ' ' _t '� .. �� . <br /> ` � � ' ��S� � � . . ;; . ' , � , <br /> ,�l.� . . . . . . ' . . . . '`�1' . . , . . � .. ;��• . <br />