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CITY OF ORONO _ APPLICATION FOR PLUMBING 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 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. �l <br /> 4. Work must 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 required. <br /> JOB SITE ADDRESS: 0/v C� S7"' <br /> Occupancy Type: Residential Comme cial <br /> OWNER'S NAME: o/D y i /cA Phone No. : <br /> Mailing Address: City: <br /> CONTRACTOR'S NAM: i^ e,eZ /�� ; Bus. No. : q y 3 y`i <br /> Mailing Address: _ -K i City: L/ic:#a:ci.4 Zip: -s- <br /> Master <br /> Master Plumber's State License No. : M 38',_ cg 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 /> ------------- - - ----- ---T----- ------ ------------- ---- -------- --------- ----- <br /> Water Closet "O1` Sewer Ejector <br /> ------------ ---�-- -- - ---- ----------- -- -- ---- ------- ---- <br /> Lavatory 1 ) Y <br /> Laundr Tray ` <br /> ------------- ---- --—---- --¢--- ---- ----- ---- -- -�—/ -- ------- ---- <br /> Bathtub Washer / <br /> ------------- ----- ------- --�-- ---- ----------- --rr^---- ------- ---- <br /> - - - - - ---- - - - - - <br /> Shower � J ----- Water Heater �-- <br /> ------------- ----- -- —r--- ------- - -------------L ---.---------------------Kitchen Sink ' Water Softner <br /> -------------I---- --- ------ ------ ----------- -- ------------------------ <br /> Disposal - <br /> �- / ----- Bar <br /> ------------ --- -- -- ----- ------------------ -----L-------------------- <br /> Dishwasher Sump Pump <br /> -------------�- - --- -- --- ---- ----------- -- ----- -------- ---- <br /> Sillcocks Misc. (List) <br /> --------------- ------------- ---- ------- ---------- ----- <br /> Floor Drains -� <br /> ------------- -- --------4--------- ------ ------------- ---- ------------------------- <br /> 1. <br /> ------- ---------- -----1. Fixture Fee The minimum permit fee is $30.00 $ 16 0 <br /> Compute number of fixtures W x $8/fixture <br /> x $5/fixture reset <br /> 2. State Surcharge $ .50 <br /> 3. Postage & Handling (Only mail-in applications) $ //// �7 — <br /> 4. TOTAL PERMIT FEE (add lines 1-3 above) $ A, 0 • � <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 rect. <br /> 61WSignature of Applicant: �, _Iz �� Date: /--91 <br />