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•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 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 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 hour notice reqnired. <br /> *************************************************************************** <br /> Jos szTE Ann�ss: ���7�% ��� ��`��r�� �' �"� <br /> Occupancy Type: Residen al Commercial <br /> OWNER'S NAME: �/� Phone No. : �7�� ��� 7 7 <br /> Mailing Address: City: <br /> CONTRACTOR'S NAME: .���' � " �l l� Bu s. No. : j 'j� �� y' <br /> Mailing Address: � < , '�� City: /� � �� Zip:_�7� =SS�:�� <br /> Master Plumber's State L cense No. : City Ce t. No. : <br /> *************************************************************************** <br /> PLUMBING 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 /> ------------- -+----- -- ------ ------------- ---- ----�---- --------- ----- <br /> --T----- <br /> ��� <br /> Water Closet Sewer Ejector <br /> Lavatory Laundry Tray <br /> Bathtub Washer <br /> ------------- -----�---—---- ------ ----- ----------- -- ------- ------- ---- <br /> Shower Water Heater <br /> Ritchen Sink 'I Water Softner <br /> -------------j---- -•----- -------- ---- ----------- -- --•---- -------- ---- <br /> Disposal Wet Bar <br /> -------------1---- --_--- ------- ------ ------------ -- --.---- -------- ---- <br /> Dishwasher I_ Sum Pum <br /> -------------1 ---- ---- -- -------- ---- --p----p--- -- ------ -------- ---- <br /> Sillcocks Misc. (List) <br /> Floor Drains (,�'i��t'r `�PT�" <br /> ------------- ----- ---y---- --------- ------ -- --------- ---- ---�---- ---------- -1-- <br /> *************************************************************************** � <br /> 1. Fixture Fee The minimum permit fee is $30.00 $ <br /> Compute number of fixtures x $8/fixture <br /> x $5/fixture reset <br /> 2. State Surcharge $ .50 <br /> 3. Postage � Handlinq (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 /> 7 <br /> Signature of Applicant: cJ���- !/�� Date:--�� ,.� <br /> �C� C�(� /7�� _ <br />