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�CITY OF ORONO (� �j?�� APPLICATION FOR PLUMBING PERMIT <br /> � Box 66 (1335 So Brown Rd) ` v <br /> Crystal Bay, MN 55323 <br /> *************************************************************************** <br /> General instructions <br /> 1. You may apply for plumbing permits by mai_1 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 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. <br /> 24 hour notice required. <br /> *************************************************************************** <br /> JOB SITE ADDRESS: 2650 Town Hall Road, Orono, MN <br /> Occupancy Type: Residential X Commercial <br /> OWNER'S NAME: City of Orono Phone No. : <br /> Mailing Address: City: rono, <br /> CONTRACTOR'S NAME:Allied Mechanical Systems Bus. No. : 612-587-7930 <br /> Mailing Addresss 340 Michigan St. , P.O. Box City: Hutchinsan Zip: 55350 <br /> Master Plumber's State License No. : 002257PM 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 OTHER <br /> ------------ �----- ---T----- ------ ------------- ---- --------- --------- ----- . <br /> Water Closet Sewer E ector <br /> -------------�---- ---L�--- ---- ---- ------ -------'----- ---- --�--- --------- ----- <br /> Lavatory �� Laundry Tray U <br /> Bathtub � -____ Washer <br /> ------------ ----�--- ---- -------- ------------- --- --- -- --------- ----- <br /> Shower ' ------ Water fieater <br /> -------------�-----�--.�--- -------- ------------- ---- ---.�---- --------- ----- <br /> Ritchen Sink 'I __--__ Water Softner <br /> -------------1---- -•�--- ------- ----------- ---- --•�-- --------- ----- <br /> Disposal - Wet Bar <br /> -------------1---- -.-�- ----- ---- ------------ ---- ---.�- --------- ----- <br /> Dishwasher I_ � Sum Pum <br /> -------------1 --- --- -- ------ ----- --p----p---- --- ---O-- ------- - ---- <br /> Si11COCks Misc. (List) /`S � P `�''^ � ,., t�`�. <br /> • o <br /> � <br /> ------------- ----- --- --- --------- ------ ------------- ---- ------- -�i�.JSiC, =-r=.r <br /> Floor Drains �"'°"��'` r-� `-"�"��� <br /> „ <br /> --��- - <br /> *****************************************************************ir********ir _ <br /> 1. Fixture Fee The minimum permit fee is $30.00 $ ��(� � �)[� <br /> Compute number of fixtures Y>.� x $8/fixture <br /> x $5/fixture reset . <br /> 2. State Surcharge $ .50 <br /> 3. Postage b Handling (Only mail-in applications) $ 1.50 <br /> 4. TOTAL PERMIT FEE (add lines 1-3 above) $ (p(�(p• �U <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 certi.fies that all statements made on this <br /> application are complete, true and correct. <br /> Signature of A�;�;li.cant: Date: S-i5 -ci a <br />