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� <br /> CITY OF ORONO APPLICATION FOR PLUMBING PERMIT <br /> Box 66 (1335 So Brown Rd) <br /> Crystal Bay, MN 55323 � <br /> *************************************************************************** <br /> General Instructions <br /> 1. You may apply for plumbing permits by mail 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 wfll 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 conatruction 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 honr notice reqnired. <br /> ***********************p**************************************************** <br /> JOB SITE ADDRESS: �� b � ��V � (`c����J�` �-L1 �(n.r 1i �V'C. <br /> Occupancy Type: � Residential Commercial <br /> OWNER'S NAME: �� �� � �=�^ �lC� t1 Phone No. : �� � � �l� , <br /> Mailing Address: __ .L , �f 1,.� �,�� City: � ��t�.y �v <br /> CONTRACTOR'S NAME: C� P P �'� y'h'�j 1 ° -- Bu s. No. : �-{7 l �-. I � <br /> Mailing Address: � � ,. �. City: Y7\`7;,�,� Zip: �. �.�-� <br /> Master Plumber's State License No. : City Cert. No. : <br /> *************************************************************************** <br /> PLIIMBING FIXTURE SCHEDULB <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 /> ------------- ---- ----+----- ----r----- ------ ------------- ---- ----^---- --------- ----- <br /> Water Closet_�_ Sewer Ejector <br /> ------------ --- ---—---- ---- ---- ------ ------------- ---- ---�----- --------- ----- <br /> Lavatory Laundry Tray <br /> Bathtub Washer <br /> ------------- -----�------- -- --- ------ ------------- ---- ---^---- --------- ----- <br /> Shower Water Aeater � <br /> ICitchen Sink- ----- --,----- --`---- ------ Water Softner ---- - -•----- --'u� ----- <br /> -------------�---- --�----- ------- ----- ------------- ---- ---�---- -- --- ---- <br /> - - - - --- - - <br /> Disposal �_ ______ Wet Bar <br /> Dishwasher Sump Pump <br /> Sillcocks Misc. (List) <br /> Floor Drains <br /> *************************************************************************** <br /> l. 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 & Handling (Only mail-in applications) $ 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 certifiea that all statements made on this <br /> application are complete, true and correct. <br /> Signature of Applicant: � �' � � Date: l�� `��. <br /> . . . �' . . . '.f.,,. . . . , ,..� ... <br /> . � �a � U' � �,,�: <br /> � . . � . j�".'� . . . . . . . .. ' � . . . . . ..Y• � . . . <br />