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� <br /> CITY OF ORONO APPI,ICATION FOR PLUMBING PERMIT <br /> Box 66 (1335 So Brown Rd) - <br /> �- <br /> � . ` Crystal Bay, MN 55323 �'%; `-_`�� <br /> *************************************************************************** <br />� General Instrnctions <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 will be sent by return mail the same day the application is received. <br /> 3. Yermits are not valid until you receive a perm.it 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 honr notice reqnired. <br /> ****************************** ******** *********************************** <br /> JOB SITE ADDRESS: `�,/J� �G' ��J� �iz� lCc.�_.. <br /> Occupancy Type: " Residential Commercial <br /> OWNER'S NAME: ,���i�J`��7 - � -�eS���'�="`�one No. : <br /> Mailing Address: City: <br /> CONTRACTOR'S NAME: �� ��d� �'�� ��`�-�> % '�"" � Bu s. N . : �������� <br /> Mailing Address: �✓i<J �-�.---�-`� City: � Zip. �� <br /> Master Plumber' s State License No. : - �� City Cert. No. : <br /> ********************************************** **************************** <br /> - � PLUMBING FIXTURE SCHEDULE <br />:_ - (Show number of fixtures of each ty�e on each floor) <br /> FIXTURE TYPE BSMT 1ST FLOOR 2ND FLOOR OTFiER FIXTURE TYPE BSMT 1ST FLOOR 2ND FLOOR OTHER <br /> . . � ______���____ ��_ ___-i__��_ ___T_���� ___��� ___�__��_____ _��� ��__^__�� _____�___ _�_' <br /> V:ater Closet i-_-_�- �7 Sewer Ejector � <br /> ------------ --��-- --- ---- ------ ------------- ---- ---•----- ---------}----- <br /> Lavatory � i � Laundry Tray � � <br /> � <br /> -------------�----�--—----}-------- ------ ------------- ---- ---�----- ---------L----- <br /> � � � � � <br /> Bathtub � � Washer <br /> ------------------- --�---- -- --- ------ ------------- ---- --------- ---------. ----- <br /> � <br /> Shower -----_y_--_ i, / Water fieater � <br /> _ . � ------- ! ^--�----- ------- ------ Water Softner�---- ---�----- ---------I----- <br /> , - Ritchen Sink � j / � _1_f , _ <br /> ------------- _�- ---- ---------?------ ------------ --- -------- ---- - <br /> i ; <br /> Disposal �---- i / I_ Wet Bar / ---------i <br /> ------------ I '-------- ------ -1 ----- ------------ ---- ---•---- r----- <br /> I I <br /> Bishwasher / _---_- Sump Fump ---______ <br /> -------------1-----�----�--- ---�- ---------- ---- ------- - ----- <br /> � . Sillcocks � Misc. (List) <br /> Floor-Drains_ C __ �!�--- ---�----- ------ ------------- ---- ------- ---------- ----- <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 /> 2, State Surcharge $ .50 <br /> - 3. Postage & Handling (Only mail-in applications) $ 1.50 <br /> 4. TOTAL 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 certifies that all statements made on this <br /> application are complete, true and correct. <br /> Si nature of A licant: ,�� ����""Z� Date• �/'"! � <br /> g Fp � <br />� <br />