�8/22/2016 10:28 FA� 9529�35049 CULLIGAN MNTKA C�1002
<br /> � City of Orono �� ;FOR E ONLY;: �
<br /> �`� d P.O. Box 66 �'Dete;�Rece'i;ved: ����;'r,i�'� '�h?
<br /> '„y,," �"��''�
<br /> 2750 Kelley Parkway ;,,�:;,,, ,,,p,. ; r,,^•,'�.y: �„������,,. ,p� ^;j;�',,.�:
<br /> � C stal Ba MN 55323 �'I1Q�T�jt:#,';'�'. ;�;;�;��M�;������'�I;���+A�:��� _���Y;;;;
<br /> s .�' �Y Y, ..�";:.�I,;rc;h;�,.��;,,:�r, �, �;,r, "�';�"� .� �'�,
<br /> , ��
<br /> ,v.i;:;
<br /> „�,,,, ,,,., .., ,,,:,. � � ,,?�.�. , .
<br /> " ,,,,,,,, .,,,
<br /> s � �� (952)249�600—Main A rr,.,. ,,,.,.M�.. i ,,,,, ., .��,,,.,� ,
<br /> �.
<br /> , i ,. „r•�,;�s�.,,.� ,,�,�I,�
<br /> ,,,,,,�„,,,,.,,.,� ,,,��„�.„�, ��.�;��'�.... ,,.,,
<br /> �,i�
<br /> ���� ;,,.��.,�,,,,�: ;�ii, i���,��,�,���.,�,,,�,„
<br /> �� , �d�IIG'� ,;�,�.�,.�.,�
<br /> � ppyoved Sy , ,,.�;::���.,..,i,;�,�:��. .;,:,.�,�,�,.,,,,�,�,�,..�
<br /> �tFsrto¢ (952)249-4616—Fax � ,u.,,��.'�:�u;: .�••, ,,,p.' l,,.l "'�,�i�';:;i
<br /> "'�'����.,�,��,��,�,���:r Gr:� , T . �,I:^:��,I�,c,�II;,,;J�;�;
<br /> ��A'mount�$�,,,iiW��'�"��;i ;��..�,,��,,.,.,���,��,,,,„��o�,.,,,�,r�,�.��,�,,,,.���,
<br /> CITY �F ORONQ— PLUMBING PERMiT
<br /> (AI) Commercial Permits Must be Approved by the State P�ior to City Approval)
<br /> http:l/www.dli.mn.aov/CCLDlPDF/qe plumbplanr�vaQp.pdf
<br /> , , „����d�,�.,�.o-„�, .�,�������:�..����.II,—. �„ ,. ,,,,..,�.,4,,.,,a�„�a��..�,��,�,�.,,��.��.ur�,.��:,�ar,„„i,„,����,�r,�ix��,.��.i,,,, „.�.,�,,�,;,., ,,,,,� ���.�n,��"�.�, ,.��a�,.'ail.,��aP�IP�fl�i�r,
<br /> ,
<br /> "'dl' � I� I a� ,' ,���,�,,,,�,.I.i.��„��,.,Y����r�,�ll•�I „ i,��„L�.,�,,,�..�,.,, ��,.� ��I,lI�..�,,,„�I�,..,�r, ,., ,,,�6•�•I���.�,�
<br /> ,� . . . . ,,.� ����,��.I,����.,..���,��,,,,, '��,������ ��,�����i,i,�Mr ,„'oP��'�';��:f„'Id,:P���tf�l�':'ll;.fY11,l��,i,��„�.�„��„�� a.����l�,i������1.���„'�.�ii.�.���,.,��o�.,M.��l ' �„��,�
<br /> ,GENER,4L;INFORMA,TI�N..,,,�,��,.;„;,�„��.,��,,,�.�,��.,.,,,,,��.�,.��„�,:�,,,,..,�,�:,r�,.�.:,.���,�„��.,.�.,�� ,.,� �,. �,.� � ��,�,,,,,,.����,.i�,�,�,r,,,,�.�,,,,,,,,�,.,.,.,,,��.,�„..,,. ...I.,I,,,.,,,�„��,.,,,,��,,,,,..�,,.�,.�.,
<br /> 1. You may apply for plumbing permits by mail or in persan at the City of�ices. Applications wifl be
<br /> reviewed and a permit will be issued within iwo working days.
<br /> 2. Permit cards will be sent by return mail a�ter a review is completed. PERMITS AR� NOT VALID
<br /> UNTIL YOU RECEIVE A PEI�MIT. WORK MUST NOT BEGIN UNT1L THE PERMIT CARD IS
<br /> POS7ED ON THE JOB SlTE.
<br /> 3. Plumbing permits may be issued QNLY to licensed plumbing contractors and to property owners
<br /> residing in the dwelling.
<br /> 4. When any new construetion or remodeling is involved, a separa#e building permit must be obtained_
<br /> 5. All work must be done in accordance with State Code requirements.
<br /> 6_ A11 work must be inspected and air tested before it is covered. Gall (952)249-4600.
<br /> (24�48 hour notice reyuired)
<br /> ��.� .��ii.,�.n,ti.��� � � � '. . „��„�,��,..,��,�.���� ���„���„��„ii���.ii.�����.�.�,��.ii�.ir n�...i����.x�ixr,i.ieliw''i�Ji• �� aih�.x �„q�i.
<br /> �•wil,..l.��;l'��II;�,��M11x�G�l.l iu1,�„ �i� ��i.6�bu�l.���u.nd�,u„� ,�. r�I�L'd"�JI" :'I,•.,' "I��H�.��7��IiJ"�:II'4�..; �����.,rGh� I"{I�iCI'� ,SI�CI'�I:�
<br /> .� .,. �� ,���r. .�„�.�„ .��.�� ,�� �,����v.u� .�.�w�
<br /> ,,,Ir�.����,��.Jd�,� ,�I,�.I.���;: �i�dw":IGCi.P�;i����;�L�.�.���1.,„�,�,. f,., n,/l .�I.�.�w��l�i. �..��:� �I�1ry��C�:l{'1�'q':wu��wo.�'iN„�l��ii�„�i..�o��.iai.l
<br /> . „ �� , ,�•��
<br /> ,�.�.�F. ���,,,„��, r n ,,,,�,�w�,�
<br /> �,.��a,. „r,,.,��.,,�„w'i;�•rr,r .,i.�,m�l'YPE,��OlF.,�RERMfT,Check 1 That.A., 1 ���,i���,�„.�,�-i,.�,���M�;.,w��,�,i,,,�r����.,���. „���,;.�; ..,w.,.l�.,.,,..,�
<br /> I�A����,i��ii�i�.��ii.o�i.ii`IC��„L�i�,I�.�.,I..L,J,,,, rrh�i�I�i�iPiii:Hi���il;C� ,,.r,., ,d,..., m„V� �,•� ,•,F'C,�,7,/iSi ,il� ��� NI II w�r4�Y"�+irl.�'IJ� ,m�i+
<br /> �Residential ❑ Commercial (Appro�al Required) [Hac�low Device:❑A.VB ❑pVB]
<br /> �New ❑Additional ❑ Repairs � Replace
<br /> ❑ fn Accessory Structure?
<br /> *You will need pria�anprvval and may need CUP. (Per Orana City Code, Chapter 78, Article 1�
<br /> �„ ,,, .,,,,,,:,,,,�w„,�a�,,,
<br /> � , wi�l� i��i.. ��„„� � n.n�+n.�„�,� n����.,����u�i�����,ia.I��I,iu�����miMu�,uu�in,iq�Hw�..�S��
<br /> �.��•��7 S lf e/„ ��
<br /> , . .,,,� Owne .,, ,,,,,, a . , ,,.., ,I.,,, u.�,,. ,. ,.���.��.,.,.� ,
<br /> . ,.
<br /> �,�� ',;,,,,.�� .���., ��. f inf���,,,.� . ���I�i�.�Gi��b�r���.��1. ii������oi.i�,�i�u�,e,�l.low�y�:
<br /> ,,,� rm ion °r ,�,.
<br /> Site Address: _� � � 5 f��r�-�1� ��n p�. ��
<br /> Owner: ��Qa .���ov-. _ Mailing Address:
<br /> �7'
<br /> City: Zip: S.S,�,�'I
<br /> Home Phone: 11�3� �� , 7�9� Alterna#e Phan�:
<br /> �, .,�,�„�„, �,�,�,,u „,.�.��r. ,,,�, ,���,,,,,•.I:;,,,�,r�,:;!l�ali!",'�i'ri;G;�i!�t���i'li:�',���:i�:"a��;Mi' F. ,.,...,,
<br /> ... ... „ ,��, .. ,.,�,,,„,�,,, �i�,,,�,�,„��,
<br /> ,�.., �.. .��,..,.. r ��,�� ,�,., I..„I,'C;�'�I,
<br /> .,
<br /> �.,�Contracta� �I�if.p mati+on ,.,aw,w..,..,,�,.m�,.��,.,��,a,�,,,�,w�,��.1,�,.,i'�w
<br /> Contractor: Cantact Person: ��
<br /> Address: 603o GULLIGAN WAY $fate 8ond #:
<br /> (�952) 933-7�U�
<br /> City: Zip: Expiration Date:
<br /> Phon�: Altemate Phdne:�S�,- g 1 a -�3_l_'�
<br /> [f Insurance—Current: �
<br /> Page 1
<br />
|