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CIT�' �� U1tONQ° �P�.ICAT'E�N FOIt PLTJMBIlOt�PER1iRI'T <br /> �ox b6 (2750 Kelley Parkway) <br /> �rystal �a,v, l�vIN 55323 <br /> GENERAI.INFORMATION <br /> 1. You may'apply for plumbing permits by mail or in person at the City o�ces. <br /> 2. Permit cazds will be sent by return mail after a review is completed. PERMITS ARE NOT VALID <br /> UNTIL YOU RECEIVE A PERMTT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS <br /> POST�D ON THE JOB-SITE <br /> 3. Plumbing permits may be issued ONLY to iicensed plumbing contractors and to property owners residing <br /> in the dwelling. <br /> 4. When any new construction or rcmodeling is involved, a separate building permit must be obtained. <br /> 5. All work must be done in accordance with the State Code requirements. <br /> 6. All work must be inspected a�d air tested before it is covered. Ca11473-7357. 24-hour notice required. <br /> Fnstructioii� Coa�pletP all item� on this application. Compute the permit fee. Sign and'date <br /> the certificatioii. INCO:iT2LET� AFPLICATIaNS WILL NOT BE FROCFSSED. If you have <br /> questions, call 473-7357. <br /> Please check one: �Tew �Addition Repair Replace <br /> Residential Commercial <br /> JUB SI'FE: ✓�Od �c .S �P;��� <br /> �wner'sNames '' ` TelephoneNumbers <br /> 1VIailing�iddTesS: Sdo yC�.rc�r4e�.� �.� C�tY: D��-� Zip: �,S'�;S� <br /> �antractcir'sName:�_�� �� �= /✓i�, �, l Telep�oneNwnber: + �,����� <br /> Mailing A:ddress:�2��T��:,�„��_,�(�r, City: Zip: 4 ,��� <br /> PLUMBING FII�TURE SCHEDULE <br /> FIXTURF BSMT 1ST 2ND OTHER FIXTURE BSMT 1ST 2ND OTHER <br /> TYPE ' FL FL TYPE' FL EL <br /> Water Closet Floor Drains <br /> Lavatory. Sewer <Ejector <br /> Bathtub . Laundry`Tray . <br /> Shower Wasi�er <br /> Kitchen Sink Water Heater ' <br /> Disposal Water Softener <br /> ,Dishws,sher Wet Bar <br /> Sillcocks Misc (list) <br /> ' ��,p�lG���.✓ /�.d v���/`�.-- <br /> ��.�� ���� <br />