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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 />�S 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. 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 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 /> **********,t************************ ****** ******************************* <br /> JOB SITE ADDRESS: n r <br /> � Occupancy Type: Resi en 'al Commercial <br /> OWNER'S NAME: Phone No. : ���--C� ����J <br /> Mailing Address: � �� Y�?',' City: c�1oY,.� <br /> n�-� <br /> CONTRACTOR'S NAME: � rm Bu s. . � �' �'G"7 /.� <br /> Mailing Address: �P,�' �5- �' City: ,v Zip c�,S35{� ; <br /> Master Plumber' s State Licens o. : ,?�%/ City C . No. : <br /> *************************************************************************** <br /> • < PLUMBING FZXTIIRE SCHEDULE <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 FLOOR 2ND FLOOR OTAER <br /> ------------- --- ---�----- - ------------- ---- ----�---- --------- ---- <br /> ---r----- ------ , <br /> P�ater Closet �-__-�- r Sewer Ejector � ; <br /> ------------ --—---- -- � ---- ------ ------------- ---- ---•----- ---------+------ <br /> --- � <br /> Lavator 1 � � <br /> y Laundry Tray <br /> ------------ � ---�--------+------- ------ ------------ ---- ---•----- ------ L----- <br /> _ _ - - <br /> Bathtub � j / Washer <br /> . �_�_____��___1��__^���__�� __ __� �_____ �____����___� ��_� ���^___ ���_____�r��___ <br /> Shower ' � Water Heater � <br /> -------------a---- --•---- ------ ----- ------------- ---- --•----- ---------�----- <br /> ' -= - - - � <br />- - Ritchen Sink - j Water Softner <br />- ------------------ --•---- ------- ------ ------------- ---- ---�----- -------- �----- <br /> � --�- <br /> Disposal f i Wet Bar j <br /> -------------1-----�---- ------- ------ ------------- ---- ---�---- ---------�------ <br /> Dishwasher � _---__ Sump Pump I <br /> -------------1---- ------ -------- ------------- - - - - -- ---------- ----- <br /> : . . . Sillcocks Misc. (List) � '' <br /> ------------ --- --•--- --------- ------ ------------- - - ------- ---�---- ----- <br /> Floor Drains <br /> . .- *************************************************************************** <br /> 1. Fixture Fee The minimum permit fee is $30.00 $ <br /> Compute number of fixtures x $5/fixture <br /> .�,?., <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 /> Signature of A�plicant: � � � Date: <br /> � � � <br /> � <br />