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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 will be sent by return mail the same day the application is received. <br /> 3. Permits are not valid until you zeceive 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 separ.3te 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 /> **********************rt**************************************************** <br /> JOB SITE ADDRESS: / �-Qo �,mNGA. �.�ivDA DRaN� <br /> Occupancy Type: ✓ Residential Commercial <br /> OWNER'S NAME: �� � pT �A .D E �L- Phone No. : <br /> Mailing Address: � �Qp �, � ,;�, ,y. �f�l�,� City: _ p�po �.p� � �y <br /> CONTRACTOR'S NAME: C G! L. �. / G/�-!✓ G o Bus. No. : Q 3 � • ��G fl <br /> Mailing Address: (�,0 3o c k �.�.i G-�-N �lih � City: ��-j-,y,¢ Zip: sT�-�yJ-- <br /> Master Plumber's State License No. : City Cert. No. : <br /> *************************************************************************** <br /> PLOMBING FIXTURE SCHEDULE <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 /> ------------- ---- ----a----- ---T----- ------ ----------- --- --------- --------- ---- <br /> Water Closet Sewer Ejector <br /> Lavatory Laundry Tray <br /> Bathtub Washer <br /> ------------- -----�------- -- --- ----- ----------- -- --^-- ------- ---- <br /> Shower Water Aeater <br /> -------------�----- --�----- ------- ------ ------------- ---- ---�----- --------- ----- <br /> Ritchen Sink ' -_____ Water Softner , <br /> -------------�---- --•----- -------- ------------ --�---- -------- ---- <br /> Disposal I- __-__ Wet Bar <br /> -------------1 --- ------- ----- ----------- -- --�---- -------- ---- <br /> Dishwasher Sump Pump <br /> Sillcocks Misc. (List) <br /> FloorDrains- ----- ---•--- ----•---- ------ ------------ ------- ---------- ----- <br /> *************************************************************************** <br /> 1. Fixture Fee The minimum permit fee is $30.00 $ 30 -d� <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 PERMZT FEE (add lines 1-3 above) $ � a- d O <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 /> r - , <br /> � �c <br /> Signature of Applicant: -- - �• � -- Date: jL ��/ % j / <br /> , �- . ` ,�,�,, <br /> �' ,� <br /> ,�: � ... , : • �ti: . <br />