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� � <br /> CITY OF ORONO APPLICATION FOR PLUMBING PERMIT <br /> Box 66 (1335 So Brown Rd) <br /> Crystal Bay, MN 55323 � � � � G �� '�. <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 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: ��Q �c—�s <br /> Occupancy Type: ��Residen al Commercial <br />� OWNER'S NAME: Phone No. : <br /> Mailing Address: ?,"��o �_�- City: Q��� <br /> CONTRACTOR'S NAME: I��Z�.`�G�/l��'`� �GY� Cr Bus. No. • ��(p—C'�/(7� <br /> Mailing Address: 3'�y� it,�0 City: Zip:�� <br /> Master Plumber' s State License No. : 3�'�� 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 FIXTDRE TYPE BSMT 1ST FLOOR 2ND FLOOR OTHER <br /> ------------- ---- ----+----- ----r----- ------ ------------- ---- ----�---- --------- ----- <br /> Water Closet �- �_ ---__- Sewer Ejector <br /> Lavatory Laundry Tray <br /> Bathtub Washer <br /> ------------ ----�-------- ------- - - ------------ ---- ---^-- --------- ----- <br /> - - - --- - - <br /> -�. <br /> Shower �� f � �� � ��'�r, �e �rr C � <br /> ------------- -----�-�---- -------- - -- -�— -----�'- ---- ---•--`- --------- ----- <br /> Ritchen Sink ' Water Softner <br /> -------------�---- -•---- ------ ---- ----------- -- --�---- --------- ---- <br /> Disposal �- Wet Bar <br /> Dishwasher--- ---- ------ ------- ----- Sump Pump---- ---- ---�----- --------- ----- <br /> -------------�---- --- -- --�---- ------ ------------- --- ------ ---------- ----- <br /> Sillcocks Misc. (List) <br /> Floor Drains <br /> ***************************************************rt*********************** <br /> l. Fixture Fee The minimum �,ermit fee is $30 .00 $ �O , �� <br /> Compute number of fixtures 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) $ J��J �' <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 r7innesota, and certifies that all statements made on this <br /> application are complete, true and correct. <br /> Signature of A�;plicant: Date: �..�''�3� �� <br />