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CITY OF OHONO AP LIGATION FOR PLOhtBING PERMIT <br /> Box 66 (1335 So Brown Rd) <br /> Crystal Bay, MN 55323 <br /> General Yaatructions <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 ostage and handling fees shown below. <br /> Permit cards will be sent by return mail the ame day the application is received. <br /> 3: Permits are not valid until you receive a pe. it card. <br /> 4. Mork must not begin unless the permit carcAAavailable on the job site. <br /> 5. Plumbing permits may be issued to licensed-coltractors only. <br /> 6. When any new construction or remodeling is i volved, a separate building permit must <br /> be obtained. <br /> 7. Al l work must be done in accordance with Sta a Code requirements. <br /> S. - All work must be inspected before it is co Bred. Call 473-7357. 24 hour notice <br /> required. <br /> �R�+k9bA�k+�lrtr�Ff�t�r9tsk�kllrlk+kie�k*^1����#* fe�ts��#*ask 4**'7it <br /> JOB SITE MWRZSS: <br /> Occupancy Type: er Residential --tComnnercia <br /> OWNER'S NAME: , ®//X,r/ Phone No <br /> Mailing Address: ®® City: <br /> C CTOR:'S : O�� P� i�b Bus. No. <br /> Mailing Address: . V.?116 City: <br /> Master Plumber's State License No. : 3V ,-,�6City Cert. No. : <br /> PLUMBING FI SCHEDULE <br /> (Show number of fixtures of ach type, on each floor) <br /> FIXTURE TYPE BSMT 1ST FLOOR 2ND FLOOR OTHER F XTURE TYPR BSMT 1ST FLOOR 2ND FLOOR OTHMR <br /> --e-- ------.. - ------ ----- ---- --- --- ---, ----------------------- ---- <br /> Water Closet ® - � e e ----- _ _- Laundry Tray_ __ - /-- -------- ---- <br /> - - --- -- T� ---- <br /> veto - ------------ -------- ®-- --- -- ---- <br /> Bathtub---N- -- - / ----- - ----- -4ater Heater ---'- -- ----- -------- -- <br /> -------- <br /> ----- --- ----- ------1-- ® s----- ---- —i--------- -- <br /> Shower / ter Softner <br /> �--.... ---- --------------------------- -- - ---- -------_ - ----------- <br /> -- <br /> Xitchen Sink _ �- ise. (list) <br /> — -- -------------------- <br /> -- -----_ --- --- ---- — ------ ------------ -------- <br /> Disposal <br /> --- —Disposal <br /> ----- ---- - ------- ------- -------------------- <br /> Dishwasher _ <br /> --4—Vis.----<-- ---r- —a.—s----- -------- ---- ----.--------- --------------------- --- <br /> ----- -------- ---- <br /> Wet Bar -----------------------I ----- — —_ --- -- --- ---® ----- <br /> ks <br /> Sillcoc---- --- - - ---- -- -- ------ -----® --------------------- <br /> Floor <br /> - --------Floor Drains / <br /> --------- ------ - ----- -- - ------------- ------- <br /> Supp Pump --o-- ------�- <br /> - -- - - <br /> Sewer Ejector <br /> 1. Fixture Fee The minimum permit fee is $30.00 $ <br /> Compute number of fixtures X I$4/fixture <br /> 2. State Surcharge <br /> $ .50 <br /> 3. Postage a Handling (Only mail-in iapplications) $ 1,50 <br /> 4, TOTAL PERMIT FEE (add lines 1-3 �bove) $ <br /> The undersigned hereby applies to the Ci4y 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, aid certifies that all statements made on this <br /> application are complete, true and ct <br /> Signature of Applicant:_ Date: <br /> i <br />