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CITY OF ORONO APPLICATION FOR PLUMBING PERMIT <br /> Box 66 (1335 So Brown Rd) �� <br /> _, _ �`1 <br /> Crystal Bay, MN 55323 _'L^ <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 po:stage and handling fees slaown below. <br /> Permit cards will be sent by return mail the sane day the application is re^eived. <br /> 3. Permits are not valid until you receive a permi�. card. <br /> 4. Work must not begin unless the permit card is a�.ailable on the job site. <br /> 5. Plumbing permits may be issued to licensed cont� actors only. ; <br /> 6. When any new construction or remodeling is invclved, a separate building p�rmit must <br /> �� be obtained. �'a <br /> � 7, All work must be done in accordance with State C�de requirements. <br /> 8. A1 1 work must be inspected before it is covered. Call 473-7357. <br /> 24 hour notice required. , ;r� <br /> *************************)***** ***********�*�*f'*********************�****** <br /> / ` � �,L>t� J,C�; CG�'`"�. <br /> JOB SITE ADDRESS: ��" 5 � C�mmercial <br /> Occupancy Type: L� Resid ntia L <br /> � ��,���-� ���- Phon n No. : <br /> OWNER S NAME: City: <br /> Mailing Address: <br /> �, ,���- ��-e- sus. o. : -y,� �- 7� d�d <br /> CONTRACTOR'S NAME: , - l�f�2e°a�- � ���.t,c.�.�/ Zip:,��.j�`�� � <br /> Mailing Address: ��? '`�S- ��' �� �' '`` � C1City Cert. No. : <br /> Master Plumber s State License No. : -S �� �//�Y/ <br /> *************************************************************************** <br /> PLUMBING FIXTURE SCHEDULE <br /> (Show number of fixtures of each type oi� each floor) <br /> FIXTURE TYPE BSMT 1ST FLOOR 2ND FLOOR OTHER FIXTURE TYPE f'SMT 1ST FLOOR 2ND_FLOOR OTHER <br /> ---+----- --- ------ <br /> ------------- ---- ----� <br /> ------------- ---- - -_-r----- ` <br /> Water Closet �� � -_ Sewer Ejector > <br /> ------------- - <br /> --- -------- - - <br /> Lavatory � � Laundry Tray <br /> ------------- - ---—---- --- ---- ------ ------------- /- ---•----- --------- ----- <br /> Bathtub / Washer <br /> -----�---- ------------- • --- <br /> ---^---- --------- ----- <br /> ---- ------- ------ <br /> ------------- , <br /> Shower � Water 8eater <br /> � <br /> -------------�� <br /> Ritchen Sink '} Water Softner <br /> --------------+----- --•�---- -------- ------ ------------- --- ---�----- --------- ---�- <br /> Disposal ' Wet Bar r: <br /> -------------1----- --.----- ------- ------ ------------- --- ---.---- --------- ----- <br /> Dishwasher � Sump Pump <br /> _____________1_____ ____ ___ ________ ______ _____________ ___ _______ __________ _____. <br /> Sillcocks a Misc. (List) <br /> ------------- <br /> Floor Drains ` ` <br /> 'y -�----- ------ ------ <br /> ------- ---- ---�---- ---------- ----- <br /> *************************************************��************************* <br /> 1. Fixture Fee The minimum permit fee is $30.00 $ <br /> ' xtures x $5/fixture , <br /> Com ut <br /> e <br /> n <br /> umber <br /> 0 <br /> f fi <br /> p x $3/fixture reset 1, � <br /> $ .50 `.� <br /> 2. State Surcharge <br /> 1.50 <br /> 3. Postage � Handling (Only mail-in applications) $ , <br /> 4 . TOTAL PERMIT FEE (add lines 1-3 above) $ <br /> *************************************************************************** <br /> The undersigned hereby applirictoaccordance withntheo ord nancesoofathe City andmthe <br /> agrees to do all work in st <br /> regulations of the State of Minnesota, and certifies that al l statements made on this � ' <br /> application are complete, true and correct. , . <br /> ; <br /> � Date: ��l/�— ��� ;� <br /> Signature of A�plicant: ..�����P � ��'�� � <br /> i <br /> . , . :;�i <br />