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CITY OF ORONO APPLICATION FOR PLUMBING PER'4IT <br /> Box 66 (1335 So Brown Rd) I <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. <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 /> ********************************************_I************* ****************** <br /> JOB SITE ADDRESS: 35 5 CLD Cr?S�i 1. e <br /> Occupancy Type: ZN Residential Commercial <br /> OWNER'S NAME: 1 • . C , Phone No. : -[7 (,I3 4 <br /> Mailing Address: jas Lc-1o. City: <br /> l,,/ . J. Bus. No. : X86) (9�'3- <br /> CONTRACTOR S NAME: �j.V'iD V)��O 4_.- t�//�-�'`` <br /> Mailing Address: ( n Rte, / City: A4062 U,41Zip:s-s7 <br /> Master Plumber' s State License No. : .e/picorn7 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 1ST FLOOR 2ND FLOOR OTHER <br /> 1 Tr <br /> Water Closet 1 1 J --- -1---_ TSewer Ejector I <br /> � <br /> ` i 1 j L I jLaundrY TrayLavatory II j---— <br /> ---- !-- <br /> Bathtub I ` I Washer <br /> Shower 1 TWaterHeater \ I <br /> Kitchen Sink Water Softnerj <br /> I <br /> Disposal ' Wet Bar I <br /> 1 ] Sump Pump <br /> Dishwasher 1 _ , <br /> Sillcocks i _— ----- Misc. (List)I. <br /> Floor Drains 1 <br /> *************************************************************************** <br /> 1. Fixture Fee The minimum permit fee is $30.00 $ <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) $ % e" <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 i <br /> regulations of the State of Minnesota, and certifies that all statements made on this <br /> i <br /> application are complete, true and correct. <br /> I <br /> 1 <br /> ,, t n , <br /> . a,\_ 1 <br /> Signature of Applicant• .� <br /> Date: 9 �o1� � 1 <br />