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._-_,)/ a7 <br /> 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. <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 /> *************************************************************************** <br /> JOB SITE ADDRESS: 2306 6)1 ve- 4.J. <br /> Occupancy Type: / Residential Commercial <br /> OWNER'S NAME: Ss4 SA b e'-4 Phone No. : 4�4 -64 10 <br /> Mailing Address: City: 4, X00.4,0 <br /> CONTRACTOR'S NAME: L.a-hr7 (5).1.6•6.-... Bus. No. : 1 71-5'9 gr) <br /> Mailing Address: 3 -3a IA/41,i y11 y.„,,,,,. City: , u Zip: 5....10.1. <br /> Master Plumber's State License No. : -7c'- City `C art. No. <br /> *************************************************************************** <br /> PLUMBING FIXTURESCHEDULE <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 /> Water Closet Sewer Ejector <br /> Lavatory 1 -I:::::::::::: EE:::: <br /> -- •�-- - - -ri- - - <br /> Bathtub Washer_-_ -------------- 1 <br /> _____ __________F ___- _ - 1 .- _ - <br /> Shower water Heater •, . <br /> Kitchen Sink 1. ::::::::water Softner <br /> Disposal ,wet Bar . <br /> -- -------- ----- -«---- - ;.� __ *,...•••14,,, .-:may _.. --- <br /> Dishwasher Sump Putnp <br /> --- - --- - -----”4-v------..-----.., .---*N---- -- ,... <br /> Sillcocks Misc. (List) -- <br /> Floor Drains _ <br /> .---.--...... ------ - -- --- - - - -------- <br /> *******************************************'******************************** <br /> 1. Fixture Fee The minimum permit fee i.e $30.00 "' $ ` <br /> Compute number of fixtures x $5/fixture <br /> x $3/f.ixture reset Crv�l .oa <br /> 2. State Surcharge $ .50 <br /> 3. Postage & Handling (Only mail-in applications) $ 1.5.0 <br /> 4. TOTAL PERMIT`FEE (add lines' 1-3 above) $ <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 co ct. <br /> Signature of Applicant: l ,, • / ® Date: <br />