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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 l/�* b it�. .00 <br /> 5. Plumbing permits may be issued to licensed contractors only. lr-,:, T 'L"- <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: 1/ Residential Commercial <br /> OWNER'S NAME: no AA /",a Al Phone No. : 4,- yid 677 <br /> Mailing Address: [ ,2,eZ City: G ?a ir6 <br /> CONTRACTOR'S NAME: C cit / i4 , Q Bus. No. : q 3 3 7 02 ad <br /> Mailing Address: - &,� 3� G �[�� ��,�-,y �,t.�y � City: aA/ ,-,< 9- zip: pT <br /> Master Plumber' s State License No. : City Cert. No. : <br /> *************************************************************************** <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 IST FLOOR 2ND FLOOR OTHER <br /> -------.------ ----1----- ---T----- ------ ------------- ---- --- .----- --------- ----- <br /> Water Closet ------ Sewer Ejector <br /> Lavatory Laundry Tray <br /> Bathtub Washer <br /> ------------- ----- ------------- ------------------- ------ ------- ---- <br /> Shower ------ Water Heater <br /> ------------- ----- -------- ---—---- <br /> ------- ------- ------------- ---- ---•--------------------- <br /> Kitchen Sink Water Softner <br /> ------------------- --•----- --- ---- ------ ------------- ---- ------------------------- <br /> DisposalI- Wet Bar <br /> -------------1-------- --- --------------- ------------------- -------- --------- ----- <br /> Dishwasher--- I- ------ Sump Pump <br /> Sillcocks f Misc. (List) <br /> Floor Drains <br /> --y----�---�-----�------�-------------�----�-------�----------�----- <br /> 1. Fixture Fee The minimum permit fee is $30.00 $ 3o m U <br /> Compute number of fixtures x $5/fixture <br /> x $3/fixture reset <br /> 2. State Surcharge $ .50 <br /> 3 . Postage & Handling (Only mail-in applications) $ 1.50 <br /> 4. TOTAL PERMIT FEE (add lines 1-3 above) $ 3 a. C7 <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 /> Signature of Applicant: Date: <br />