Laserfiche WebLink
CITY OF ORONO APPLICATION FOR PLUMBING PERMIT <br /> Box 66 (1335 So Brown Rd) <br /> Crystal Bay, MN 55323 <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 /> i. <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 required. <br /> JOB SITE ADDRESS: <br /> Occupancy Type: Residential Commercial <br /> OWNER'S NAME: �f 9/U% GC�G�idJ/SSTF/r Phone No. : <br /> Mailing Address: -Doe-04-If <br /> City: <br /> CONTRACTOR'S NAME: y o e-04-I f 7C of <br /> G, Bus. No. : <br /> Mailing Address: 719rS' de) -7� City: /l�C€ OLS/i?/ Zip: 6S'&-%7Master Plumber' s State License'No. : V-99U n.1 City Cert. No. : <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 /> ------------- ---- ----+----- ----r---- ------ ------------- ---- --------- --------- ----- <br /> Water Closet <br /> Sewer Ejector <br /> ------------ ------- ----- <br /> Lavatory <br /> ---- --- ----- --------- ----- <br /> ------ Laundry Tray <br /> Bathtub I- ----- <br /> Washer <br /> Shower Water Heater <br /> ------------ --- --`---- --__- ---- ------------ ---- ------- --------- ----- <br /> Kitchen Sink --_--- Water Softner <br /> -------------.l------------- -------- -------------- ---- ---•--------------------- <br /> DisposalI- Wet Bar <br /> Dishwasher---1 ---- ------- --------------- ------------------ -----Sump Pump --------------------- <br /> __________________ --------- ---____ ____ ____________ ___ ____-------------------- <br /> Sillcocks Misc. (List) <br /> Floor Drains <br /> 1. Fixture Fee The minimum permit fee is $30.00 $ so ea <br /> Compute number of fixtures x $5/fixture <br /> x $3/fixture reset <br /> State Surcharge $ .50 <br /> Postage & Handling (Only mail-in applications) $ 0 <br /> TOTAL PERMIT FEE (add lines 1-3 above) $ y <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 Applicant: 14?eA01_ Date: <br />