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� � CITY OF ORONO APPLICATION FOR PLUMBING PERMIT --�'��8 <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. r�U� �' r1 ��Ca <br /> 24 honr notice reqnired. <br /> *************************************************************************** <br /> JOB SITE ADDRESS: �C�� N�'� 1''1 �r►m D�n v�� <br /> Occupancy Type: 7� Residential Commercial <br /> OWNER'S NAM$: Y L Phone No. : �-1�oZ��_ <br /> Mailing Address• �q Y� City: ��10 <br /> CONTRACTOR'S N�-U�'1',GAN WATER CUNC�i'fi�1Nliti�, Bus. rro. : q3�- �l a�c� <br /> Mailing Address: b City: Zip: <br /> Master Plumber's ��(�j�. Zj,rj,'�,� City Cert. No. : <br /> ***************************************�F*********************************** <br /> PLUMBING FIXTDRL 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----- ------ ------------- ---- --------- --------- ----- <br /> . ---T----- <br /> 47ater Closet Sewer Ejector <br /> ------------- ---- ---—---- -- <br /> Lavatory � Laundry Tray <br /> ------------- --- -—---- -------- ------ ------------- ---- ---•----- --------- ----- <br /> Bathtub T Washer <br /> Shower Water Heater <br /> ------------- ----- --•----- ------- ------ ------------- ---- ---• ---- -- <br /> Ritchen Sink ' Water Softner � <br /> -------------�---- -------- -------- ----- ------------- ---- --------- --------- ----- <br /> Disposal Wet Bar <br /> -------------1---- ------ ------ ------ ------------- ---- ---.---- --------- ----- <br /> Dishwasher_--I_ Sump Pump <br /> --------- 1 ---- ---- --- --------- ------ ------------- ---- ------- ---------- ----- <br /> Sillcacks Misc. (List) <br /> -------------�---- --•-- -------- ------ ------------- ---- ------- ---------- ----- <br /> Floor Drains �_ l_ <br /> ------------- ---- --�----�--------- ------ ------------- ---- --------�----------�----- <br /> *************************************************************************** <br /> l. Fixture Fee The minimum permit fee is $30.00 $ �r"J �JQ <br /> Compute number of fixtures x $8/fixture <br /> x $5/fixture reset <br /> 2. State Surcharge $ .50 <br /> 3. Postage � Handling (Only mail-in applications) $ 1.50 <br /> 4. TOTAL PSRMIT FE$ (add lines 1-3 above) $ �- f ' ��' <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 /> , <br /> `__ �✓ r ,, �� <br /> Signature of Applicant: � � ��'� " T��.�, ate: C�" l-= � _ <br /> ���� AN WATER <br /> `'; <br />