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� - �` ' �TY OF ORONO r�PPI,�C�TION �OR PLUMBING PERMIT <br /> C <br /> Box 66 (1335 So Brown Rd) <br /> Crystal Bay, MN 55323 <br /> *************************************************************************** <br /> General Instractions <br /> 1. You nay 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 dap 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 Iicensed 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. AlI work must be inspected before it is covered. Call 473-7357. <br /> 24 honr notice reqnired. <br /> *******************************�******** ****** ************************** <br /> JOB SITE ADDRESS: �� S�� ✓`JL�-'�"��'�� 'z''' <br /> -. - Occupancy Type: � Residential Commercial <br /> OWNER'S NAME: Phone No. : <br /> Mailing Address: City: <br /> Q 4 •"7 � <br /> � � CONTRACTOR'S NAME: l,'ulG i c. �' ��-CL��'�✓ � �� Bu s. �o. : � � C �� .7� �� <br /> F <br /> Mailing Address: � `�` ��^ £.c° c! City: �'' � Zip. �-_� •0 j ;, <br /> Master Plumber' s State License No. : ,;' .3 7_� '�' City C t. No. : ��� `' <br /> *************************************************************************** <br /> � PLIIMBING FIXTIIRE SCHEDIILE <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 OTHER <br /> ---^---�----- ------------- ---- --------- -- <br /> ------------- _T----- <br /> __T � �' r _ __-- Sewer Ejector T r <br /> kater Closet , I <br /> ___________ 1____.________�__ I______ _____________�____ ___._____ _________ _____ <br /> i � // � Laundry Tray F� i <br /> Lavatory (/ __Y ____ � � <br /> . �������������i�������L-����i�������� ������ ������������� ����i� ��������������� <br /> Bathtub i j I Washer � / <br /> ------- I I-------�-- --- ------ ------------- --y---^— ---------�----- <br /> ------ --- <br /> i -- <br /> Shower / � Fiater Heater l_ �_ i <br /> � �������'���� y ������J._����� �`���� ������ ������������� ��� ��'����� i����� <br /> � f� ' � <br /> =.._.:, Ritchen Sink � _---_ Water Softnerl � <br /> . __________________________ _ _�____ _ _____________1____1________ _______________ <br /> _,_ : , <br /> Bisposal <br /> � ' Wet Bar I <br /> 1------------ ------- ------ ------------- ---- ---�---- ---------�----- - <br /> ------------- I <br /> , . <br /> Dishwasher I � Sump Pump <br /> � <br /> ' --------- ------ ------------- ---- ------- ---------- ----i <br /> _ . �������������i�����r����.��� <br /> Sillcocks , Misc. (List) <br /> Floor Drains <br /> -----�------- --�-- ---�---- ---�----- ------ ---------� <br /> *************************************************************************** <br /> l. Fixture Fee The minimum permi� fee is $30.00 $ � t% <l�' <br /> Compute number of fixtures � x $5/fixture <br /> x $3/fixture reset <br /> 2. State Surcharqe $ .50 <br /> - 3. Postage & Handling (Only mail-in applications) $ 1.50 <br /> 4. TOTAL PERMIT FEE (add lines 1-3 above) $ _� � �'�ti <br /> f � <br /> ******************************************************,r******************** <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 t ' <br /> regulations of the State of Minnesota, and certifies that all statements made on this ; <br /> application are complete, true an correct. � ' <br /> � <br /> . . � f � ] ` <br /> Signature of Applicant: � � , �"�`J Date: � 'Z-Z� � <br />� <br />