Laserfiche WebLink
� �� CITY OF ORONO APPLICI�TION FOR PLUMBING PERMIT �C�� <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 officea. <br /> 2. Mailed in applications are subject to the postage and hand.ling 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 muat 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 muat 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********,************** *�f*************************** <br /> JOB SITE ADDRESS: �� I�S '" ,� ��_I <br /> Occupancy Type: �,.�- Resident'al Commercial <br /> OWNER'S NAME: `�� �L ��yv:� �__ ,_ Phone No. : <br /> Mailing Address: r �� . City: _ L7rz.r�,�;� <br /> CONTRACTOR'S NAME: '�� � N � � Bus. No. : �3� J�I�� <br /> � �j:yv\ t�v t'c,. �� <br /> Mailing Address: � >� ��-' ity: � � Zip:`J;`�.3 <br /> Master Plumber's State License No. : � 5�- City Ce t. No. : <br /> ****************************************,t**********************rt*********** <br /> PLUMBING FIXTURE SCHEDULB <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----- ------ -------j----- ---- --------- --------- ----- <br /> Water Closet � Sewer E ector <br /> ------------- ---- -------- ---- ---- ------ ------------- ---- ---�----- --------- ----- <br /> Lavatory / Laundry Tray <br /> Bathtub Washer <br /> ------------- -----�-------- ------- ------ ------------- ---- -------- --------- ----- <br /> Shower � __-__ water Heater <br /> --------------�----- --•----- ------- - ------------- ---- ---•----- --------- ----- <br /> Ritchen Sink 'l --__-- Water Softner <br /> -------------+---- --�----- -------- ------------ -- ------- ------- ---- <br /> Disposal I_ ______ Wet Bar <br /> -------------1 --- ---- ----- --------- -- --•---- -------- ---- <br /> Dishwasher Sump Pump <br /> - -- - -- --- --- ---�---- ------ ------------- ---- ------- ---------- ----- <br /> Sillcocks Misc (List) /� - <br /> ------------- ----- ---•--- --------- L_-1 :v--•,1 _ `�%Uv"Z <br /> ---- ----------- --- ---�-- ---�- ---- <br /> - - - - - - - -,-- - <br /> ,� , <br /> Floor Drains ` <br /> ------------- ----- ---�---- --------- ------ ------------- ---- - ��:���1 �='------- ----- <br /> ,t**********************rt*************************************************** <br /> 1. Fixture Fee The minimum permit fee is $30.00 $_ �: � r �` �� <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) $ �C� , � � <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 /> regulationa of the State of Minne$dta, and certif�es that all statements made on this <br /> application are complete, true ar�e7�correct. ; <br /> , . <br /> � � . <br /> � <br /> Signature of Applicant: --�'``���-- Date: /� �'3-y1 <br /> � Y�a. a :1• •*� <br /> .<,. . . . <br />