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CITY OF ORONO APPLICATION FOR PLUMBING PSRMIT <br /> Box 66 (1335 So Brown Rd) <br /> Crystal Bay, MN 55323 : <br /> , *******#******************************************************************* <br /> General Instrncti�s <br /> 1. You may apply for plumbinq permits by mail or in person at the City officea. � <br /> \ 2. Mailed in applications are sub ject to the postage and handlinq fees shown below. <br /> Ij�` Permit cards will be sent by return mail the same day the application is received. - <br /> ; �� 3. Pesai.ts are not valid uatii yon receive a persit card. <br /> 4. Work muat not beqin unless the permit card ia available on the job site. <br /> � 5. Plumbinq permits may be iesued to licensed contractora only. , . <br /> 6. 1Phen any new construction or remodelinq iB involned, a aeparate buildinq permit must <br /> be obtained. _. - <br /> 7. All work muat be done in accor8ance with State Code requirements. <br /> 8. All work must be inspected before it is covered. Call 473-7357. <br /> 24 honr notice required. <br /> *******************�j`* ******** ******************************,�***********�t* <br /> JOB SITS ADDRSSS: 7��S - � <br /> Occupancy Type: U Resid tial Commercial <br /> OT�INER'S PAN�: �� = Phone No.: <br /> Mailing Address: City: <br /> CONTRACTOR'S NAMB: � �Su s. No. : ���'"" �6 �C� <br /> Mailing Address: City: Zip: 5.5�v y <br /> Master Plumber's State License No. : y/ ry1 City Cert. No.: <br /> � *****************************************�********************************* <br /> j PLDMBING FIXT[1R$ SCHSDULB <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 OT$ER . <br /> ------------- - ----a----- ---T----- ------ ------------ ---- ----�---- --------- ----- <br /> water Closet / / sewer sjector � <br /> ------------- - -------- ----�---- ------ ------------- ---- ---•----- --------- ----- <br /> Lavatory � ( � Laundry Tray � ' <br /> Bathtub �: ' Washer � - <br /> • Shower ------ � ------- -- j -- ---' Water_Heater -- --�.--- --`- - ----- <br /> Ritchea Sink _� . �_ Water Softner ` <br /> : . . <br /> ' .- Disposal � Wet 8ar , <br /> Dishaasher Sump Pwnp , <br /> ---------- --- --�•- - -- — - - ----- ----------- -t- --- -------- --- <br /> Sillcocks � Misc. (List) �� <br /> Floos Draina � <br /> ------------- ----- ---+=--- --------- ------ ------------- ---- -------- -�-------- ----- <br /> *************s*****rr***********************************************�t******* <br /> ' 1. Fiatnre Fee The minimum permit fee is $30.00 $ <br /> _. _ <br /> Compute number of fixtures - x $5/fixture � . <br /> x $3/fixture reset Of I � <br /> - f _ <br /> �2. State Surcharge $ .50 <br /> ; .. _ _ <br /> � `. 3. Postage � Handlinq (Only 'mail-in applications) $ ._ :_� . 1.50 ..,. ._ _ , ..: <br /> , . :. <br /> _ . . 4. TOTAL PBRMIT FEE (add lines 1-3 above) _ _� :. _ $ _ .; . .. �-- :- <br /> . _ - - **************,t*****************************************+t****************** --_ <br /> . . _ . ,_ , _,_ : <br /> . <br /> ` The undersigned hereby applies to the City of Orono for iasuance of a Plumbing Permit, ' � : <br /> agrees to do all work in etrict accordance with the ordinancea of the City .and the <br /> regulationa of the State of Minneeota, and certifiea that all atatements made on this <br /> application are complete, true and correct. _ <br /> _ _ . . _ _ .. :, . .� <br /> Signature of Applicant: ` Date:- 6 "�� �/ - .- <br />