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^�� CITY OF ORONO _� � APPLICATION FOR PLIIMBING PERMIT <br /> Box 66 (1335 So Brown Rd) <br />�� Crystal Bay, MN 55323 <br /> *************************************************************************** <br /> General instrnctions <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 nntil yon receive a pernit 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. <br /> 24 honr notice required. <br /> *****************,t****,t**** ************,t**************,t*******,t*********** <br /> JOB SITE ADDRESS: �U ' �v <br /> Occupancy Type: "Re den ial Commercial <br /> OWNER'S NAME: s''�'Vl--� I'�,�Lc� • 1 Phone No. : �7 Z ' � 3�`7 i <br /> Mailing Address: � i 90 (t,uwo _ City: U�e,�;t� <br /> CONTRACTOR'S NAME: c, � Bu s. No. : � Z�• Z S 3� <br /> Mailing Address: x>C Z` b � City: � Zip: SSyD�j <br /> Master Plumber's S ate License No. : �- 5 � � City C rt. No. : <br /> *************************************************************************** <br /> PLUMBING FIXTIIRE SCHEDQLS <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 OTHER <br /> ------------- ---- ----+----- ---�----- ------ -------- ---- --------- ---- --- � <br /> Water Closet �_ �- _____ Sewer Ejector �_ <br /> ------------- --- , --—---- ---- ---- - ------------- ---- ---•----- ----4��---- <br /> ; <br /> Lavatory � + ___-_- Laundry Tray Z,.� -�-�, � �� f�„� 2c-L� <br /> -------------•----�-------- ------ ----------- �-� ---•----- --------- -�3�ti,�f /x���t <br /> Bathtub � Washer <br /> � <br /> --------------�----= ------- -- --- ------ ------------- ---- ---^-- -L�------ ----- <br /> � -- <br /> Shower � Water Heater � <br /> -------------�---- --•---- ------ ----- ------------- ---- --{C---- --------- ----- <br /> , <br /> -� - - - <br /> I j <br /> Ritchen Sink � 1 Water Softner <br /> ------------ ----�------ ------- ------ ------------- ---- --------- --------- ----- <br /> Disposal i ( __ Wet Bar <br /> -------------1---- -------- ------ ---- ------------- ---- ---•---- --------- ----- <br /> Dishwasher __�_ S�P P�P <br /> Sillcocks Misc. (List) <br /> Floor Drains <br /> ------------- ----- ---�_--- --------- ------ ------------- ---- --------- ---------- ----- � <br /> *************************************************************************** <br /> 1. Fixture Fee The minimum permit fee is $30 .00 $ <br /> Compute number of fixtures x $8/fixture <br /> x $5/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 ta 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 /> � <br /> Signature of A�plicant: .-C -'Z L/ u� Date: �`/ 9� <br /> , <br /> j' �' <br />