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��VI <br /> CITY OF ORONO APPLICATION FOR PLUMBING PBRMIT <br /> Box 66 (1335 So Brown Rd) <br /> Crystal Bay, MN 55323 <br /> *************************************************************************** <br /> General Instrnctions <br /> � <br /> 1. You may apply for plumbing permits by mail or in person at the City officea. <br /> 2. Mailed in applicatione are sub3ect to the postage and handling feea shown below. <br /> Permit cards will be sent by return mail the same day the application is received. <br /> 3. Permi.te are not valid until pou receive a pe:ait card. <br /> 4. Work must not begin unless the permit card is available on the job site. <br /> 5. Plumbing permita may be isaued to licenaed contractora only. <br /> 6. When any new conatruction 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 /> *************************************************************************** <br /> JOB SITE ADDR$SS: <br /> Occupancy Type: � Residential Commercial <br /> OWNER'S NAMB: Phone No. : <br /> Mailing Address: City: <br /> CONTRACTOR'S NAME: � ' ' ' Bus. No. : <br /> Mailing Address: City: Zip: <br /> Master Plumber's State License No. : City Cert. No. : <br /> *************************************************************************** <br /> PLUMBING FIXTURE SCBEDULB <br /> (Show number of fixtures of each type on each floor) <br /> FIXTDRE TYPE BSMT 1ST FLOOR 2ND FLOOR OTAER FIXTURE TYPE BSMT 1ST FLOOR 2ND FLOOR OTHER <br /> ------------- ---- ----a----- ----r----- ----- ------------ ---- ----�---- --------- ----- <br /> Water Closet � Sewer Ejector <br /> ------------- ---- -------- ---- ---- ------ ------------- ---- ---�-�---- --------- ----- <br /> Lavatory ! Laundry Tray , <br /> ------------- ---- --—---- --------- ------ ------------- ---- ---•----- --------- ----- <br /> Bathtub Washer <br /> ------------- ----- ------- -- --- ------ <br /> ------------- ---- ------�--- --------- ----- � <br /> Shower � <br /> Water Aeater <br /> . , r <br /> Ritchen Sink Water Softner <br /> ------ ----- . <br /> Disposal � Wet Bar <br /> ------------- ----- ---L---- ------ ----- ------------- -- --•---- -------- ---- <br /> Dishwasher ' Sump Pump <br /> --- ----- <br /> Sillcocks Misc. (List) <br /> Floor Drains <br /> , <br /> � ������������� ����� ���i���� ���.►����� ������ ������������� ���� ���r���� ���������� ����� <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 /> 3. Postage & Handlinq (Only mail-in applications) $ 1.50 <br /> 4. TOTAL PRRMIT FBE (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 certifiea that all statements made on this <br /> application are complete, true and correct. <br /> � <br /> Signature of Applicant: ��. �_._���� - Date: <br />� -. - -- � <br />