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/ <br />� CITY OF ORONO � / � �� APPLICATION FOR PLUMBING PERMIT � <br />� Box 66 (1335 So Brown Rd) <br /> 7 Cryst�l Bay, MN 55323 . <br /> a <br /> * :�**��********************************************************************** <br />? General Instructions <br /> 1. You may apply for plumbing permits by mail or fn peraon at the City offices. <br />! 2. Mailed in applications are subject to the postage and handling fees ahown below. <br /> jPermit cards will be sent by return mail the same day the application is received. <br />? 3. Permits are not valid nntil 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 invol ved, 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 reqnired. <br /> *************************�********** ******* ***************************** <br /> JOB SITE ADDRESS: � J \-'� I� � � �L,- <br /> Occupancy Type: � Residential Commercial <br /> •—' , <br /> OWNER'S NAME: I �'L� �1 '� � ��'1 `� � Phone No. : <br /> Mailing Address: City: <br /> CONTRACTOR'S NAME: J A�ec-iL ( b�- Bus. No. : �' L�- �(c�I <br /> Mailing Address: ,�C � v: �c� � � City: /yP�yr_�- � Zip:�'�'%�_C) <br /> Master Plumber' s State License No. : t !%"� 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 Ejector ' <br /> ------------ -� - --- --- ----------- -- --•-�--- ------- ---- <br /> - - - �- - - - - - - - - - - - - - <br /> Lavatory ' _-_r�--__ ' --_-_- Laundry Tray <br /> ------------- --- -------- ------------- ---- ---•�---- -------- ----- <br /> Bathtub � _____- Washer I <br /> ------------- -----�-------- --�---- ------------- -- ---^--- --------- ----- <br /> i - - <br /> Shower � -__--- Water Heater <br /> ------------ -�-- --�---- ----- ----------- � --�---- ------- ---- <br /> Ritchen Sink ') I _--___ Water Softner <br /> -------------+---- --•----- -------- ------------- ---- --�----- --------- ----- <br /> Disposal I_ I Wet Bar � f <br /> -------------1 --- ---- ----- ---- ----------- -- --•---- -------- ---- <br /> Dishwasher -_ I_ � - Sum Pum <br /> ----------- 1 --- -- - --� -- ---- --P----p--- -- ------ -------- ---- <br /> Sillcocks i� Misc. (List) � <br /> Floor Drains _�- <br /> *************************************************************************** <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 /> .� <br /> 3. Postage & Aandling (Only mail-in pplications) $ 1.50 <br /> 4. TOTAI. 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 /> � , � � <br /> � <br /> �7 ` �.:� � � � �• � � <br /> Signature of Applicant: � �J " Date: _� ��� <br />