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���7� <br /> � CITY OF ORONO APPLICATION FOR PLUMBIN6 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 fn 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 muat 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 /> JOB SITE A.DDRESS: �1t'i l) G�''�(/�'� LC� ��� <br /> Occupancy Type: Residential Commercial <br /> ^ '- <br /> OWNER'S NAME: ""'�� / �^/� 11/ �' � hone No. : <br /> � <br /> Mailing Address: �Z_ �,� ' ��J �_ 't� �'u,c�� City: l ��-Y��` <br /> ' -.� (�'� �-f.t�= ' �- � <br /> CONTRACTOR S NAME: W C��� /' C� '� �-f Bus. . No. : � - Z � I <br /> Mailing Address: .�- �� � � -�� _ City: �2s' � � Zip: ��:;� <br /> Master Plumber's State License No�. : � / City Cer � No. : � <br /> *******,t******************************************************************* <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 /> ������������� ���' ���-������ ���T����� ��.���� ������������� ���� _'���.��� ��������� _���� <br /> Water Closet �_ ---_- Sewer Ejector <br /> ------------- ---- --�----- ---- ---- - ----------- ---- ---•----- --------- <br /> Lavatory Laundry Tray � <br /> Bathtub Washer � <br /> ------------- ----�------- ------ ------ ------------ ---- ---^---- --------- ----- <br /> - , - - <br /> Shower Water Heater <br /> Ritchen Sink 'f _---__ Water Softner <br /> � -------------1---- -�---- ---�--- ----------- -- --�---- --------- ---- <br /> Disposal I_ Wet Bar <br /> -------------1 --- ---- ----- ---- ----------- -- --•---- -------- ---- <br /> - - - - - - - - - - - - - - <br /> Dishwasher__-I_ __-_-_ Sump Pump ' <br /> --------- •1 --- --- -- ---�--- ------------ -- ------- ---------- ----- <br /> Sillcocks Misc. (List) <br /> ------------- ----- ---•--- --------- ------ ------- -- <br /> Floor Drains ��Q.�t�Y- :�(►y � <br /> *************************************************************************** ' <br /> l. 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 certifiea that all statements made on this <br /> application are complete, true and correct. <br /> . ^ <br /> ��� �(/`v����ZG� � ��� � � <br /> Signature of Applicant: � Date: <br /> v <br />