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� , . <br /> '� CZTY OF ORONO r�PPLIC�TION s�OR PLUMBING PERMIT � <br /> Box 66 (1335 So Brown Rd) <br /> Crystal Bay, MN 55323 <br /> *************************************************************************** <br /> General Instrnctions <br />�' 1. You may apply for plumbinq 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 will be sent by return mail the sa�re day the application is received. <br /> 3. Permits are not valid until pon 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: /Z�G' `�-�..m�- ���� � <br /> - � Occupancy Type: �G Residential Commercial ' <br /> OWNER'S NAME: ,��r� ��� Phone No. : �/7 Z -- ,��/ 7 }� <br /> Mailing Address: /yY� -�� � � City: � <br /> CONTRACTOR'S NAME: �-t�%-�'iGG ~ Bus. No. : �-S�--� L o-� <br /> Mailing Address: �O� �tiC' =-a�-� �� City: �- u. Zip: .s-S3S�-�— <br /> Master Plumber's State License No. : v City Cert. No. : <br /> *************************************************************************** <br /> ,. . PLOMBING FIXTIIRE SCHEDIILE <br /> (Show number of fixtures of each ty�e on each floor) <br /> _ FIXTURE TYPE BSMT 1ST FLOOR 2ND FLOOR OTHER FIXTURE TYPE BSMT 1ST FI,OOR 2ND FLOOR OTHER <br /> � ------------- ---�----�----- --T---�- ------ ------------- ---� --------- --------I ---- <br /> �:ater Closet � r -___�_ Sewer Ejector�- j � <br /> _____________1_-_-�__-�---- ---� _____ -_-_-_____--_ ___ -__'�-___ _-_______ _--__ <br /> � <br /> i � Laundry Tray � <br /> Lavatory ; � <br /> -------------�--------—---- --^--- ------ <br /> ------------- ---- ---•----- ---------L----- <br /> i ; <br /> Bathtub ' i Washer I <br /> ------- i -------- -- --- ------ ------------- ---- ---------- ---------'r----- <br /> Shower y Water fieater <br /> � -------------i--------•-----I+------- ------ -------�----- ---- ---•----- ---------I----- <br /> =-..� Ritchen Sink ' � I ___�_ �Water Softner -�-_ <br /> - . ------------------ ' ------ ---- ----- ----------1� ------ ---------�----- <br /> -- -;- <br /> Bisposal I i Wet Bar � <br /> -------------1---- ----- ----- ----- ------------- ---- ---•--- --------- ----- <br /> -r- - - - <br /> i , ; <br /> Dishwasher `I ' Sum� Pump <br /> - ����-��--����1�--�-���'—'��� .�-'����� ��-�-� ������-������ ���- ��-��-� -��-��--��r.-����. <br /> . ._ . Sillcocks � I Misc. (List) <br /> Floor Drains . <br /> ------------- ----- ---�---- ---�---�- ------ <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 /> � � <br /> { <br /> - 2. State Surcharge $ •50 � � <br /> , i .: <br /> �� 3. Postage & Handling (Only mail-in applications) $ 1.50 � � <br /> . _ ; < <br /> 4. TOTAL PERMIT FEE (add lines 1-3 above) $ � <br /> . *************************************************************************** i <br /> The undersigned hereby applies to the City of Orono for issuance of a Plumbing Permit, ; ; <br /> i�, agrees to do all work in strict accordance with the ordinances of the City and the + <br />�1 regulations of the State of Minnesota, and certifies that all statements made on this � <br /> application are complete, true and correct. � <br /> _ , <br /> Si nature of Applicant: sv.=�- -�—'{'�� Date: �^�9 �� t <br /> g <br />